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Skills
Background Investigationunmatched
Billingunmatched
Billing Recordsunmatched
Case Managementunmatched
Communication Skillsunmatched
Corporate Complianceunmatched
Customer Support/Serviceunmatched
Documentationunmatched
Driver's Licenseunmatched
Federal Laws and Regulationsunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Incident Managementunmatched
Insuranceunmatched
Maintain Complianceunmatched
Medicaidunmatched
Microsoft Officeunmatched
Organizational Skillsunmatched
Plan Meetingsunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Quality Assuranceunmatched
Regulationsunmatched
Support Documentationunmatched
Writing Skillsunmatched
Description
Background/Education Required:
Bachelor’s Degree in related field. Master’s preferred. Experience in working with individuals with disabilities, case management, quality assurance, compliance driven and investigative experience a plus.
Physical Requirements for Position:
Detailed computer work
Extensive phone contact
Sits for majority of day
Normal Office EnvironmentSpecial Requirements for Position:
Valid driver’s license that meets agency’s and insurance company’s standards (ongoing throughout employment)
Completion of all mandatory training sessions as required by organization and regulatory agencies.
Completion of criminal background check, abuse and neglect check and subsequent clearance by OPWDD and agency guidelines.
Position works flexible hours, including evenings, weekends and holidays as dictated by the particular needs of participants..
Must be proficient in Microsoft Office applications and have the ability and willingness to learn other agency specified software applications.
Excellent verbal and written communication skills.
Customer Service Skills and Professional in all interactions
Ability to handle large case load and work in a face paced environment.
Duties & Essential Elements (not inclusive)
Maintains communication with participants, families and other service providers on an ongoing and as needed basis.
Adheres to all agency, state and federal rules of Confidentiality, Incident Reporting and Management, HIPAA and
Corporate Compliance.
Participates in service plan meetings and any other necessary meetings to plan and problem solve for participants.
Reviews all service related documentation for compliance with NYS and Federal Medicaid regulations.
Performs Quality Assurance functions ensuring invoices, billing documentation and support staff timesheets adhere to
participant’s plan of service following the valued outcomes that are in participant’s ISP.
Reviews and investigates any concerns identified by participant, family, staff, and or contractors along with Agency assigned
investigator.
Abides by NYS Code of Conduct and Ethics reporting any allegations of abuse suspected, observed, or discovered per