Medicaid Program Advisor

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.Medicaid Program Advisor – Albany, NYItem 1042SummaryThis position will be responsible for compliance program activities in the Center of Healthcare Data Innovation. The compliance program covers the submission of records by facilities against pre-defined targets as defined by NY Public Health Law Section 400.18. The primary responsibility of the position will be to carry out established compliance program protocols. This will include setting deadlines, tracking submissions against targets, the reviewing existing processes/documentation for improvement, and generating reports. The incumbent will be expected to coordinate and communicate effectively with submitters, subcontractors, and office leadership. This position includes supervision of subcontractor tasks.Responsibilities:Monitor the shared mailbox and answer phone tree calls in collaboration with submitter engagement for timely response to submitters, especially pertaining to compliance inquiries.Initiate monthly compliance reporting and perform quality checks on reports before approval for public website posting.Perform monthly compliance reconciliation to send compliance warning notices to submitters not meeting compliance metrics on compliance and audit reports.Supervise processing of submitter requests for compliance exceptions and extensions.Review code sets with other subject matter experts and system vendor for annual system update.Education of facility submitters of requirements for compliance with submissions.Participate in development of submitter management system development and quality assurance testing to ensure the system is functioning appropriately.Documentation of compliance activities in appropriate trackers.Desired CharacteristicsAbility to work independently with excellent organizational, written, and oral communication skills.Effective time management skills to meet program timelines.Proficiency in Microsoft Office products, including Word, Excel, and PowerPoint.Experience with staff supervision and educational training.Knowledge of Statewide Planning and Research Cooperative (SPARCS) program and data submission requirements (837R Health Care Claim Transaction – Data Reporting).Experience with hospital revenue cycle including medical coding (CPT-4, ICD-10-CM) standards and medical claims (837I Health Care Claim Transaction – Institutional, 837P Health Care Claim Transaction – Professional).Medical coding certification through American Academy of Professional Coders (CPC, CPC-H) or American Health Information Management Association (CCS, CCS-P).Experience with healthcare compliance programs.Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an e-Verify participant.Job DetailsPay Type SalaryEducation Level Equivalent ExperienceTelecommute Percentage 50Hiring Min Rate 68,800 USDHiring Max Rate 86,000 USD