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About the Role

Responsible for order compliance and management of provider credentials and demographics to ensure regulatory compliance and contribute to positive cash flow.

Responsibilities

• Monitor orders in the Mosia escalations folder and perform necessary follow-up.
• Provide education and support to Medical Records staff regarding Mosia and indexing.
• Monitor reports and Mosia tracking features to ensure goals of Orders Lifecycle are met.
• Perform follow-up for timely receipt of unsigned Orders, including calls to physician offices and communication with Clinical team members/managers.
• Elevate unresolved issues to Team Leader or Manager.
• Document actions in the system to support compliance with internal policies and regulatory guidelines.
• Verify credentials, including licensing, NPI, PECOS, OPRA, and OMIG/OIG/GSA sanctions, for new Providers and update the system.
• Monitor and maintain Add/Change Physician workflow, including provider additions/changes, updating demographics, and delivery methods.
• Develop working relationships with Physician offices.
• Mail, track, and file signature attestation letters for new MDs.
• Communicate regularly with the manager to ensure maximum compliance with orders.
• Perform other duties as assigned.

Requirements

• Demonstrated ability to apply critical thinking to tasks.
• Outstanding customer service and communication skills.
• Medical knowledge/terminology is a plus.

Skills

• Order compliance
• Provider credential management
• Demographics management
• Regulatory compliance
• Medical Records
• Mosia
• Indexing
• Orders Lifecycle management
• Physician outreach
• Clinical team communication
• Issue escalation
• Documentation
• Credential verification (licensing, NPI, PECOS, OPRA, OMIG/OIG/GSA sanctions)
• Add/Change Physician workflow
• Provider demographic updates
• Signature attestation letter management
• Communication

Location

• In Office

Work Type

• Full-time
• Onsite

Experience Level

• 2 years experience in Medical Records or healthcare setting with a full understanding of a Medical Records Specialist role (if no degree)

Education Level

• Associate's degree required

About the Company

• The Compliance Specialist is primarily in an office setting and may be exposed to outdoor conditions.
• Sedentary work: Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
• Physical Requirements: Regularly expected to stand, sit, hear, walk, talk, stoop or kneel, and perform repetitive motion.