Graham Healthcare Group

Auditor

• The Internal Controls Specialist will be responsible for the execution and support of Graham Healthcare Group’s (GHG) quarterly and annual SOX compliance program.
• Maintenance of quarterly and annual SOX/Graham requirements in accordance with established schedules and deadlines
• Assist with annual SOX testing requirements, which include testing of existing and newly implemented controls
• Create accurate and detailed audit work papers clearly describing the work performed, results of testing, and conclusions reached
• Perform weekly and quarterly monitoring’s
• Assist in the definition of remediation plans, activities and retesting for potential issues and process improvement opportunities.
• Maintain current knowledge regarding changes to SOX compliance regulations and ensure that GHG adjusts methodologies in response to the changes by drafting guidance and instructions to the appropriate stakeholders and personnel.
• Assist with various ITGC compliance requirements which could include:​
• Assist in the performance of semi-annual User Responsibility Matrix reviews for core systems
• Reviewing audit logs and implementing corrective actions where needed
• Maintenance of internal control documentation (policies, procedures, narratives, test plans, etc.)
• Assist in completion of annual assessments related to systems including disaster recovery and sensitive data evaluations
• Determine and recommend improvements to current risk management controls as needed.
• Assist management with updates to the control environment to align with system implementations and system changes ensuring alignment with identified risks
• Ability to travel no more than 10% of the time

Internal Auditor

Administrative Assistant

• Complete daily assignment of clinical field staff
• Complete scheduled workflow by assigning appropriate team members to planned frequency of visits as supported by the Clinical Supervisor
• Plan and assign clients to clinical staff based on close proximity and staff availability as supported by Clinical Supervisors
• Maintain mail process within Hospice department
• Order and coordinate removal of DME for patients and track information related to the DME process
• Assist with the HCHB scheduling component for visiting staff as supported by the Clinical Supervisor
• Coordinate the preparation of information needed for IDT meetings and monitors completion of same
• Communicate necessary information to the hospice management team and to clinical providers to ensure coordination of services
• Effectively utilize computer software applications (MSWord, Excel, Access, PowerPoint)

Hospice Administrative Assistant

Billing Specialist

• Support the Team Lead and Billing Supervisor to ensure timely and correct claims are filed with all respective payers and intermediaries for Hospice patients.
• Monitor claims for timely processing of payments and rejections and work on Accounts Receivable (A/R) weekly.
• Bill for Medicare/Medicaid/Blue Cross and other commercial payors under Hospice guidelines
• Complete/update room & board admissions/discharges in CHAMPS, Medi System
• Complete Illinois Medicaid & Managed Medicaid Enrollments/Discharges and submit to the State of Illinois
• Obtain Medicaid rate letters from facilities when rates are updated
• Update room and board rates in HCHB as required
• Process workflow in HCHB to set up room and board
• Develop and maintain relationships with skilled nursing facilities (SNF)
• Complete and submit HPF form to SNF within 24 hours of admission
• Manage monthly Medicaid billing for SNFs
• Communicate directly with Sales Team when SNF invoice payments are being held
• Monitor monthly Medicaid eligibility and maintain PPA updates
• Review unbilled reports for Medicaid and commercial room and board claims weekly
• Review Blue Cross 5th Level Claims in web-DENIS for payment dates
• Create and review room and board/respite invoices for accuracy
• Submit reviewed room and board/respite invoices to SNF for their review, obtain signatures, and correct any discrepancies
• Submit room and board invoices to AP, adhering to deadline date
• Review revenue and expenses related to room and board to ensure that payments sent to facilities tie to the payments received by the insurance carrier and the accounting system
• Update billing notes and follow up as required
• Review all payor remits filed in OneDrive by Accounts Payable
• Prepare and submit write-off/bad debt documentation to Hospice Billing Manager by monthly deadline for Revenue Cycle
• Work closely with AP department to resolve payment issues
• Perform claims adjustment/correction in CHAMPS, Medi, Waystar, web-DENSI, and commercial payor web portals.

Internal Auditor

Hospice Administrative Assistant

Hospice Billing Analyst