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Compliance Coordinator
Medical Review Institute of America, LLCCompliance Coordinator managing corporate-wide compliance activities related to regulatory compliance and accreditation at MRIoA. Collaborating across departments to ensure adherence and support during audits.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in regulatory compliance and accreditation standards, with a strong focus on managed care and utilization review. Proficient in training, auditing, and maintaining compliance documentation while ensuring adherence to Medicare Part D requirements.
Highest-signal resume keywords
Regulatory ComplianceAccreditation StandardsManaged Care KnowledgeTraining and EducationAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Regulatory ComplianceAccreditation StandardsManaged Care KnowledgeQuality ImprovementData AnalysisAudit ManagementMicrosoft WordMicrosoft ExcelMicrosoft PowerPointDocumentation Management
Soft Skills
Customer Service SkillsAnalytical ThinkingOral CommunicationWritten CommunicationOrganizational Skills
Tools & Technologies
Learning Management SystemCompliance Management Software
Industry Keywords
URACNCQAHealthcare ComplianceFraud, Waste and AbuseMulti-State Regulatory Requirements
About the role
Key responsibilities & impact- Staff level position responsible for designated corporate-wide compliance activities in the areas of regulatory compliance and accreditation.
- To support the designated activities of the Compliance Department.
- To provide company-wide support in regulatory compliance and accreditation requirements.
- To support all accreditation and regulatory filings as requested.
- Assist with management of the corporate compliance program components as requested.
- Provide timely updates and open communication with the Vice President, Chief Compliance Officer and Compliance Manager.
- Assist with the provision of staff training on the subjects of regulatory compliance and accreditation standards and maintain documentation of all training.
- Assist with management of the company Learning Management System as requested.
- Support the review process for all corporate policies and procedures as requested.
- Prepare and submit state and accrediting body filings, applications, and reports.
- Prepare, submit, and review monthly exclusions checks on all employees and reviewer contractors.
- Prepare, distribute, and present required compliance reports, submissions, etc., to regulatory and accreditation bodies.
- Assist with providing employee and reviewer orientation and training/continuing education on operational processes regarding compliance with regulatory requirements and accreditation standards as requested.
- Assist with internal and external audits conducted by or through the Compliance department and/or initiated by clients, outside agencies or regulators.
- Gather, review, and analyze data required for such audits.
- Assist with all follow up related to these audits, including internal reporting, monitoring and facilitating corrective action plans and process improvements.
- Ensure compliance with Medicare Part D requirements and Fraud, Waste and Abuse policies.
- Support legal concerns including but not limited to record requests, subpoenas, depositions, and releases of information as requested.
- Assist with investigation and reporting of privacy and security incidents as requested.
- Support all Quality Management initiatives as applicable.
- Participate in the Complaint process as requested.
- Maintain a flexible schedule.
- Participate in all Company meetings and committees as requested.
- Complete other duties and responsibilities as requested.
Requirements
What you’ll need- Exceptional customer service skills.
- Exceptional analytical and critical thinking skills.
- Excellent oral and written communication skills and interpersonal skills.
- Exceptional orientation to detail.
- Excellent organizational skills.
- Ability to work under pressure and meet deadlines while managing multiple high priorities and maintaining a flexible schedule.
- Strong working knowledge of managed care and utilization review accreditation standards, including URAC and NCQA, and multi-state regulatory requirements.
- Thorough knowledge and understanding of the Company’s clients, products, departments and work flows.
- Personal computer literacy and competency in use of Microsoft Word.
- Competency in Microsoft Excel and Power Point preferred.
- Ability to maintain a high level of objectivity and confidentiality.
- Minimum of two years in healthcare, health insurance, and/or managed care arenas preferred.
- Experience in compliance and/or quality improvement activities within a healthcare organization preferred.
- Experience in providing small group or individual training preferred.
- Experience in research beneficial and preferred.
Benefits
Comp & perks- healthcare
- vision and dental insurance
- a generous 401k match
- paid vacation
- personal time
- holidays
- growth and training opportunities
- team atmosphere with fun events and prizes scheduled throughout the year