Compliance Specialist

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 oversight of the classrooms, as needed. The Compliance Specialist must meet the requirements to be an Early Childhood Developmental Specialist (ECDS) and may assist in ensuring all required classroom documentation is timely and accurate, including the Individualized Treatment Plan. This position may also ensure appropriate habilitation services in areas of cognition, communication, social/emotional, motor and adaptive skills; or to reinforce skills learned and practiced in occupational, physical and/or speech therapy.The Compliance Specialist acts as the local Compliance Officer and HIPAA Security and Privacy Officer for their designated Center.Summary Of Essential Job FunctionFollow Arkids Pediatric Day Centers’ Employee Handbook, Management Policies and Procedures Manual, and Medical Policies & Procedures ManualEnsure all policies and procedures are implemented by staff members, maintaining compliance at all times with all regulations determined by regulatory agenciesMaintain 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 agenciesMaintain open communication with parents, families, visitors, all Arkids Pediatric Day Centers’ personnel, and outside contactsAttend and actively participate in job-related functionsRepresent the program to parents/guardians, visitors, and the public in a positive wayMake 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 visitsMay 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 vanMay perform light housekeeping dutiesOther duties as assignedSubmit any required authorizations or extension of benefits (EOB) to the gatekeeper(s) to Medicaid)Manage all Medicaid denials and appealsReceive all therapy evaluations and monitor all re-evaluations, ensuring copies of evaluations are forwarded to parents/guardians and PCPs when completedMaintain a list of upcoming re-evaluations as a double-check system and submit it to the therapists the month before it is dueMaintain a tracking system on each patient that monitors/tracks all EIDT, authorizations, DMS-642s, and any other enrollment itemsSubmit for new DMS-642s 1 month prior to the expiration date on all patients or the same day of a new evaluation if the prescribed minutes changeManage the storage system for patient medical records and other documentationAssist with managing the thinning of all active patient charts, as neededCreate a hard chart on each patient within 1 week of enrollmentComplete chart reviews on all patients after 2 weeks of enrollment and every 90 days thereafter, including 10% in discharge patientsIssue deficiency sheets, as needed, and ensures all corrections are completed by the responsible individual within 72 hours, as indicated by their signatureInitiate and manage the discharge process for all patients discharged from the Center, ensuring all required notifications are sent out appropriatelyOpenly communicate with the Center Director and/or Program Administrator before beginning the process of discharging any patientIf a patient still qualifies for any therapy, the Compliance Specialist will ensure a therapist from that discipline(s) has spoken with the parent/guardian in an effort to transition the patient from the EIDT program to the Outpatient programActively participate in weekly Administrative MeetingsUpdate their sections of the Administrative Meeting Agenda and submits it to the Center Director the day before the scheduled meeting (unless otherwise specified)Assist with the intake process and coordinating of admissions, as neededAssist with monitoring the daily attendance and follow up on absences, as neededSearch by the patients’ names before you create a new profile, they may already be in the systemEnsure all profile information is accurate and up to date on all new patientsUpdate Patient Frequency for therapy immediately when the new prescription to treat is receivedClose out customers when switch from contingency to EIDTMonitor and update the Unbillable Tab a minimum of weeklyReview the New Customer Report a minimum of weekly to ensure the contingency customers and the Arkids/EIDT customers are changed over and correctEnsure DNQ is marked/unmarked as appropriate, along with the billing datesReview the Patient Profile to ensure it is accurate and currentEnsure completion of each discipline tab for service billing dates and repeat this step for any added customerCheck inbox daily (for example: looking for evaluation notification to update DMS-642)May assist with billing for the classroomsEnsure a positive emotional climate for the patients by showing respect to children and adults through a willingness to help othersMay 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 ITPMay provide guidance and supervision of classroom planning and activitiesMay 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 classroomMay assist with updating treatment plans, goals, and objectives and distribute to classroom staffMay assist with scheduling and coordinating ITP meetings at a minimum of annuallyMay assist with ensuring the approved developmental assessment is administered timely and appropriately to all potential patient and enrolled patientsMay assist 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)Minimum RequirementsBSE 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 Education5 years of experience in Early Childhood Education or related field preferredClear Criminal Record Check, Arkansas Child & Adult Maltreatment Regulatory Checks, FBI Regulatory Check, including National Sex Offender RegistryMay be asked to complete New Director OrientationPass a drug screen (upon hire, annually, and/or randomly)Travel as neededValid Arkansas Driver’s License, including a P endorsement if neededClear Driving RecordAbilities RequiredAbility 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 dayAbility to demonstrate basic computer skills Paid Time Off, Medical, Vision, Dental, Supplemental Insurances, Life Insurance, 401k*