Audit and Regulatory Specialist

Medical Service Company

Cleveland, Ohio

JOB DETAILS
SKILLS
Accidental Death and Dismemberment (AD&D), Analysis Skills, Auditing, Billing, Customer Relations, Dental Insurance, Documentation, Durable Medical Equipment, Employee Assistance Plan, External Audit, Healthcare, Insurance, Internal Audit, Interpersonal Skills, Investigative Reports, Maintain Compliance, Medicaid, Medical Billing, Medical Equipment, Medicare, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Psychiatry and Mental Health, Quality of Life, Record Keeping, Regulations, Regulatory Compliance, Regulatory Requirements, Risk, Staff Training, Team Player, Training/Teaching, Tuition Reimbursement, Vision Plan, Writing Skills
LOCATION
Cleveland, Ohio
POSTED
4 days ago
At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).
 

MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!
 
MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.
 
In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success! 
 
Join Our Team!
 
We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days.  Benefits included!
 
Apply today to become a part of our dynamic team!
  • Competitive Pay, Commissions, Auto & Mileage Reimbursement
  • Advancement Opportunities
  • Medical, Dental & Vision Insurance
  • HSA Account w/Company Contribution
  • Pet Insurance
  • Company provided Life and AD&D insurance
  • Short-Term and Long-Term Disability
  • Tuition Reimbursement Program
  • Employee Assistance Program (EAP)
  • Employee Referral Bonus Program
  • Social Recognition Program
  • Employee Engagement Opportunities
  • CALM App
  • 401k (with a matching program) / Roth IRA
  • Company Discounts
  • Payactiv/On-Demand Pay 
  • Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays
General: Under the direction of the Director, Regulatory, Compliance and Risk, Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; and recommending opportunities to strengthen the internal control structure. Verifies assets and liabilities by comparing items to documentation

Responsibilities and Duties:              

  • Responsible for replying to and tracking of external audit activity for a variety of payers including Medicare, Medicaid and commercial payers
  • Appeals of denied audits
  • Conducts internal audits to assure compliance with policy changes driven by Regulatory Requirements
  • Developing and providing employee training on compliance policies, practices, and reporting systems
  • Identifying, investigating, and reporting compliance issues, irregularities, and violations
  • Assist with maintenance of branch records including all regulatory requirements such as licenses, etc.
  • Tracking and responding to patient grievances
  • Other Projects as required
Minimum Qualifications:     
 
Education:     Graduate of an accredited high school or GED equivalence.
 
Experience/Knowledge/Skills/Physical Requirements:
  • DME Industry experience, preferably in a regulatory capacity
  • Analytical skills refer to your ability to break down a problem, gather facts, and find a logical solution.
  • Demonstrated ability to use Smartsheet, Microsoft Excel, Word and PowerPoint
  • Familiarity with Medicare, State Medicaid and commercial insurance   billing and reimbursements as related to DME
  • Excellent verbal and written communication and customer relation skills.
  • Excellent interpersonal and organizational skills (a team player).

 

About the Company

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Medical Service Company