Compliance Coordinator - Los Angeles, United States - MedPOINT Management

    MedPOINT Management
    MedPOINT Management Los Angeles, United States

    2 weeks ago

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    Description
    Job Description

    Job Description

    Summary
    MedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards.

    Our Code of Conduct sets forth our expectations of management, employees, and contractors to act in accordance with applicable laws and Company policy.

    MedPOINT's Compliance Department works to ensure our culture maintains ethical standards and strives to significantly reduce the risk of fraud, abuse, and waste in the health care industry and enhances quality of services and care to patients.

    MedPOINT's Compliance Program is guided by the Federal Sentencing Guidelines for Compliance Programs. Reporting to the Compliance Supervisor, the UM

    Delegation/Compliance

    Coordinator has the responsibility to fulfill the following:

    Duties and Responsibilities
    1.

    Prepare and submit audit universe reports to external auditors from health plans
    2.

    Review and validate audit documents to external auditors from health plans
    3.

    Assist with internal quality reviews of department processes
    4.

    Participate in Regular and Ad Hoc Compliance Committee meetings
    5.

    Back up personnel for communicating reminders to business owners for upcoming external audits for universe selections, pre-audit materials, and approaching corrective action deadlines
    6.

    Interface with various departments for compliance related activities as needed
    7.

    Miscellaneous projects as assigned to support Regulatory Affairs & Compliance department
    8.

    Adhere to MedPOINT Management's core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration

    Minimum Job Requirements
    ·

    High School diploma or equivalent.
    ·

    Experience in an HMO or in a Managed Care setting preferred.
    ·

    Experience in

    healthcare/referral

    clerk
    ·

    Experience in general customer service

    Skill and Abilities
    ·

    Advanced knowledge in Microsoft Applications, specifically Excel.
    ·

    Knowledge of EZ CAP a plus.
    ·

    Knowledge in Utilization Management referrals processing and regulations a plus.
    ·

    Professional demeanor, excellent communication and interpersonal skills.
    ·

    Strong organization skills and knowledge of managed care environment.

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