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HCR Home Care · 14 hours ago

Provider Compliance Specialist

Rochester, NY

Full-time

Onsite

Entry Level

2+ years exp

HCR Home Care is focused on providing quality care, and they are seeking a Provider Compliance Specialist to ensure optimal regulatory compliance in physician data management. The role involves monitoring orders, assisting medical records staff, and verifying physician credentials to maintain compliance with internal policies and regulations.

ConsultingHealth CareHome Health CareHospitalityRehabilitation

Responsibilities

Monitor orders which are in Mosai exception folder and perform necessary follow-up

Assist Medical Records staff as needed with indexing of orders

Provide education and support to MR staff as it pertains to Mosai orders indexing, to ensure timely and appropriate follow-up

Review orders to ensure compliance and follows-up on issues identified until resolved, including but not limited to missing or wrong level signatures, incorrect address, missing dates, etc

Communicate with clinical field staff and supervisors as needed regarding assistance needed to resolve orders issues. Notify clinical staff of any changes MDs have made to orders which could possibly affect the patient’s care

Monitor orders approaching 30-day compliance and perform necessary follow-up. Document all actions taken to ensure compliance with internal polices and DOH regulations

Update MD preference list, which includes MD Special requests, and ensure orders are in accordance with this list

Verify physician credentials including: licensing, NPI, PECOS, OPRA, and OMIG/OIG/GSA sanctions, for new MDs. Verify MD licensure monthly, including researching any expiration and other issues identified, and Update system accordingly

Monitor and maintain add/change physician workflow, including: physician adds, physician demographics, as well as changes in corresponding orders as needed

Monitor and maintain add/change facility workflow, including facility additions and changes in facility addresses

Mail, track, and file signature attestation letters for new MDs

Perform audit of MD signatures per Corporate Compliance workplan

Communicate regularly with manager to ensure maximum compliance with orders for optimal regulatory compliance

Other duties as assigned

Qualification

Medical RecordsOrder CompliancePhysician CredentialingCritical ThinkingCommunication

Required

Associate's degree required

In lieu of degree, at least 2 years experience with Medical Records in a health care setting with a full understanding of Medical Records Specialist role

Knowledgeable in medical order compliance

Demonstrated ability to apply critical thinking related to order compliance