Compliance Specialist

About the role

The Compliance Specialist will work with the Patient Care Coordinator and other administrative staff to oversee and monitor all aspects of coordinating patient care, including maintaining all documentation while the patient is enrolled in the Center. This position will acquire approval for treatment and act as the Privacy Officer. This position may also assist in overseeing the classrooms, as needed.

Responsibilities

• Follow Arkids Pediatric Day Centers’ Employee Handbook, Management Policies and Procedures Manual, and Medical Policies & Procedures Manual
• Maintain standards set forth by Arkansas Minimum Licensing, Division of Provider Services and Quality Assurance (DPSQA), Medicaid, Arkansas Department of Health, EQHealth (or other gatekeeper to Medicaid), and all other regulatory agencies
• Maintain open communication with parents, families, visitors, all Arkids Pediatric Day Centers' personnel, and outside contacts
• Attend and actively participate in job-related functions
• Represent the program to parents/guardians, visitors, and the public in a positive way
• Make home visits (with other staff) as needed for various problems such as patient absences, assessment for environmental risk, to obtain required documentation, signatures, etc.
• May assist with marketing visits
• May fill in for other positions (ex. cover the front desk for the Administrative Assistant, cover breaks for Classroom Staff)
• May assist with loading/unloading the van
• Perform light housekeeping duties
• Submit any required authorizations or extension of benefits (EOB) to the gatekeeper(s) to Medicaid)
• Manage all Medicaid denials and appeals
• Receive all therapy evaluations and monitor all re-evaluations, ensuring copies of evaluations are forwarded to parents/guardians and PCPs when completed
• Create a hard chart on each patient within 1 week of enrollment
• Complete chart reviews on all patients after 2 weeks of enrollment and every 90 days thereafter, including 10% in discharge patients
• Issue deficiency sheets, as needed, and ensures all corrections are completed by the responsible individual within 72 hours, as indicated by their signature
• Initiate and manage the discharge process for all patients discharged from the Center, ensuring all required notifications are sent out appropriately
• Actively participate in weekly Administrative Meetings
• Auxiliary with the intake process and coordinating of admissions, as needed
• Auxiliary with monitoring the daily attendance and follow up on absences, as needed
• Search by the patients’ names before you create a new profile, they may already be in the system
• Ensure all profile information is accurate and up to date on all new patients
• Update Patient Frequency for therapy immediately when the new prescription to treat is received
• Close out customers when switch from contingency to EIDT
• Monitor and update the Unbillable Tab a minimum of weekly
• Review the New Customer Report a minimum of weekly to ensure the contingency customers and the Arkids/EIDT customers are changed over and correct
• Review the Patient Profile to ensure it is accurate and current
• Ensure completion of each discipline tab for service billing dates and repeat this step for any added customer
• Check inbox daily (for example: looking for evaluation notification to update DMS-642)
• Auxiliary with billing for the classrooms
• May assist with developing an Individualized Treatment Plan (ITP) for each EIDT patient with 1 week of enrollment and a minimum of annually thereafter
• May assist with day-to-day staffing needs and ensure that appropriate adult-to-child ratios are maintained
• May assist with programmatic management/supervision of the educational classrooms and classroom staff as it relates to implementation of each child’s ITP
• Provide guidance and supervision of classroom planning and activities
• Assume the role as direct service provider when necessary and ensure continual supervision of children assigned to his/her care while promoting a safe, healthy environment and positive emotional climate for the classroom
• Auxiliary with updating treatment plans, goals, and objectives and distribute to classroom staff
• Auxiliary with scheduling and coordinating ITP meetings at a minimum of annually
• Auxiliary with ensuring the approved developmental assessment is administered timely and appropriately to all potential patient and enrolled patients
• Auxiliary with completing and check daily classroom billing by the designated due dates (currently Wednesdays at 11:00am for F/M/T and Fridays at 11:00am for W/Th)

Requirements

• BSE in Early Childhood Education or related field with emphasis on Early Childhood plus a minimum of 6 months of experience working with young children in a group-care setting & documentation of 12 hours of coursework in early Childhood, Child Development, Special Education, Elementary Education, Child and Family Studies, or has completed state accreditation in Early Childhood Special Education
• 5 years of experience in Early Childhood Education or related field preferred
• Clear Criminal Record Check, Arkansas Child & Adult Maltreatment Regulatory Checks, FBI Regulatory Check, including National Sex Offender Registry
• May be asked to complete New Director Orientation
• Pass a drug screen (upon hire, annually, and/or randomly)
• Valid Arkansas Driver’s License, including a P endorsement if needed
• Clear Driving Record

Abilities Required

• Ability to communicate effectively with co-workers and supervisors
• Ability to work with children
• Ability to handle multiple tasks in a very busy environment
• Ability to carry out instructions
• Ability to clean efficiently and timely
• Ability to lift up to 50 lbs
• Ability to bend, stoop, stand, walk, pull, and reach for several hours per day
• Ability to demonstrate basic computer skills

Benefits

• Paid Time Off
• Medical
• Vision
• Dental
• Supplemental Insurances
• Life Insurance
• 401k*