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Senior Compliance Specialist
FreedomCareSenior Compliance Specialist supporting Medicaid compliance, audits, and fraud investigations. Helping FreedomCare’s nationwide home-care services maintain regulatory requirements.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive knowledge of Medicaid regulations and compliance requirements, with a strong ability to conduct audits, investigate fraud claims, and maintain regulatory standards in the healthcare industry.
Highest-signal resume keywords
Medicaid RegulationsInternal AuditsExternal AuditsFraud InvestigationBilling And Coding
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Legal Document ReviewConflict ReportingQuality Assurance ReviewsExclusion ScreeningBackground Checks
Soft Skills
Detail-OrientedSelf-StarterGood JudgmentMulti-TaskingReliable
Industry Keywords
Healthcare IndustryRegulatory RequirementsFraud, Waste, And Abuse ClaimsCompliance Duties
About the role
Key responsibilities & impact- Support the compliance department by reviewing legal documents
- Conduct and respond to internal and external audits for all jurisdictions
- Assist with conflict reporting and collaborate with the finance department to resolve conflicts
- Subpoena medical records and handle general record requests
- Investigate fraud, waste, and abuse claims
- Make suggestions on next steps for FWA claims
- Serve as a resource for escalated concerns across all active states
- Perform quality assurance reviews
- Complete other compliance duties as assigned
- Maintain regulatory requirements
Requirements
What you’ll need- Bachelor’s degree and a minimum of 3 years of experience in the healthcare industry, or associate degree and a minimum of 5 years of experience in the healthcare industry
- Extensive knowledge of Medicaid regulations
- Experience with exclusion screening and background checks
- Prior experience with internal and external audits
- Extensive knowledge of billing and coding preferred
- Ability to exercise good judgment using best practices, regulations, and business processes
- Ability to work with limited supervision on complex matters
- Self-starter who takes initiative
- Detail-oriented and thorough
- Reliable and detail oriented
- Adept at multi-tasking
Benefits
Comp & perks- Medical benefits
- Retirement plans
- Wellness programs
- Fun company events
- Ongoing learning opportunities
- Competitive compensation
- Inclusive work environment
- Equal Opportunity Employer