Risk Management Specialist

Description

Do you have exceptional analytical skills? Experience in the Behavioral Health/Insurance industry? This role assists with quality control and ensures corporate compliance and adherence to regulatory requirements by monitoring internal policies and procedures and state and federal regulations.

At Behavior Frontiers you will find a professional, ethical, respectful, caring and fun work environment.

Behavior Frontiers is a well-established and rapidly growing behavioral health treatment provider serving individuals with autism and other special needs within the Healthcare Industry, Department of Education, and Department of Developmental Disabilities. Our company is dedicated to providing exceptional quality, research-based, applied behavior analysis (ABA) treatment to help our clients and their families live their very best lives.

Location: Based in El Segundo, CA

Hours: Full-time

Pay: $20-25/hour based on experience

How will you help create a World Without Limits:

The Quality Assurance Specialist is responsible for:

• Ensures compliance with established internal control procedures by examining records, reports, operating practices, and documentation and providing analytical information to the Department leadership
• Ensures compliance with state and federal agencies by studying existing and new legislation related to the company's service offerings
• Develop communications and status updates related to the corporate compliance program
• Provides guidance and information by interpreting policies and procedures: answering questions and requests, and interacting with stakeholders
• Maintains high level of confidentiality regarding company operations
• Prepares reports by collecting, analyzing, and summarizing information and trends related to the compliance program and internal audits
• Monitoring and tracking changes in payor requirements (i.e., billing codes, medical policies, prior authorizations, provider certification/license requirements, etc.) and disseminating to appropriate departments/personnel in a timely fashion
• Designing trainings and resources to assist departments in adopting necessary compliance contractual policies and procedures, as needed
• Monitoring, tracking, and reporting on upcoming/new/revised licensure requirements
• Attending payor meetings, as needed
• Special projects and other duties as assigned

Qualifications and Skills:

• Familiarity with the Behavior Health, Healthcare Compliance or Internal Audit
• Working knowledge of healthcare contracting and billing terminology preferred
• Expert proficiency in Microsoft Office Products, including Excel and Word
• Exceptional analytical and critical thinking skills
• Strong oral and written communication abilities
• Superior organizational and time management skills
• Detail-oriented and deadline-driven
• Motivated self-starter able to work independently
• Team-player able to work collaboratively across departments and roles
• Bachelor's degree in healthcare management, business, marketing, or related field

In addition, the applicant must be able to:

• Provide negative TB test results
• Produce clear FBI & DOJ fingerprinting
• Produce valid driver's license and auto insurance

Why Behavior Frontiers is perfect for you:

• Competitive pay with optional On-demand paychecks thru DailyPay - get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Paid Sick Leave
• Medical, Dental and Vision insurance
• Opportunities for career advancement
• Performance and promotion raises
• Paid mileage & drive time
• Free Telehealth: Free access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling, etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500 companies and more!
• Travel: Discounts on travel essentials including hotels, rental cars, flights, excursions, and more!
• Lab Testing Discounts: 10-80% off costs of routine lab work
• New Benefits Rx: Discounts on prescription medications from 10-80% at 60,000 locations nationwide

Please visit our website at www.behaviorfrontiers.com to learn more about Behavior Frontiers and our programs. Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.

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