Sr. Compliance Specialist

Department & Position Overview:

Our Compliance Team is looking for a Sr. Compliance Specialist who can support the compliance department in reviewing legal documents, conducting, and responding to internal/external audits, investigating Fraud, Waste & Abuse claims. The Compliance Specialist role will encompass a wide range of responsibilities that will aid the department in maintaining regulatory requirements.

Every Day You Will

• Conducting and responding to internal and external audits for all jurisdictions
• Assisting with conflict reporting and collaborating with our finance department to resolve conflicts
• Subpoena of Medical records and general record requests
• Investigating fraud, waste & abuse claims
• Making suggestions on next steps of FWA claims
• Be a resource for escalated concerns for all active states
• Quality assurance review
• All other compliance duties as assigned

Ideal Candidate Will Possess:

• Bachelor’s degree and a minimum of 3 years of experience in the healthcare industry or
• Associate degree and a minimum of 5 years experience in the healthcare industry
• Extensive knowledge of Medicaid regulations
• Experience with Exclusion screening and background checks
• Extensive knowledge of Billing and Coding preferred

Nice-to-Haves:

• Ability to exercise good judgment in using knowledge of best practices, regulations, and knowledge of business processes
• Ability to work with limited supervision on complex matters; self-starter and takes initiative
• Demonstrated ability to be detail-oriented and thorough
• Reliable and detail oriented.
• Adept at multi-tasking
• Prior experience with internal and external audits

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.