Audit and Regulatory Specialist

Medical Service Company; Cleveland (OH); Hybrid; USD 65,000 - 110,000; Full time

Benefits offered by this job

Competitive Pay

Commissions

Mileage Reimbursement

Advancement Opportunities

Medical, Dental & Vision Insurance

HSA with Company Contribution

Pet Insurance

Life and AD&D Insurance

Disability (Short/Long-Term)

Tuition Reimbursement

EAP

Referral Bonus

Social Recognition Program

Engagement Opportunities

CALM App

401k / Roth IRA

Company Discounts

Payactiv/On-Demand Pay

Paid Vacation/Sick Days/Holidays

Job summary

MSC is hiring a compliance and regulatory role in a hybrid Ohio office. The Director, Regulatory, Compliance and Risk oversees audits and controls, ensuring adherence to Medicare, Medicaid and commercial regulations. The role involves training staff and improving policies, with a strong emphasis on accuracy and ethics.

The position offers a pathway for professional growth within a reputable health‑care equipment company, with daily office presence on select weekdays and remote work on other days.

Qualifications

• DME industry experience in a regulatory capacity.
• Analytical skills to break down problems, gather facts and find solutions.
• Familiarity with Medicare, State Medicaid and commercial billing.
• Excellent verbal and written communication and customer relations.

Responsibilities

• Reply to and track external audit activity for Medicare, Medicaid and commercial payers.
• Appeals of denied audits.
• Conduct internal audits to ensure policy changes are followed.
• Develop and provide employee training on compliance policies and reporting systems.
• Identify, investigate, and report compliance issues, irregularities, and violations.
• Assist with maintenance of branch records including regulatory licenses.
• Track and respond to patient grievances.
• Perform other projects as required.

Skills

Regulatory compliance

Auditing

Analytical thinking

Communication

Team player

Education

High School Diploma or GED

Tools

Smartsheet

Excel

Word

PowerPoint

Job description

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).

MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!

MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.

In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!

Join Our Team!

We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days.

Benefits included!

• Competitive Pay, Commissions, Auto & Mileage Reimbursement
• Advancement Opportunities
• Medical, Dental & Vision Insurance
• HSA Account w/Company Contribution
• Pet Insurance
• Company provided Life and AD&D insurance
• Short-Term and Long-Term Disability
• Tuition Reimbursement Program
• Employee Assistance Program (EAP)
• Employee Referral Bonus Program
• Social Recognition Program
• Employee Engagement Opportunities
• CALM App
• 401k (with a matching program) / Roth IRA
• Company Discounts
• Payactiv/On-Demand Pay
• Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

General

Under the direction of the Director, Regulatory, Compliance and Risk, Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; and recommending opportunities to strengthen the internal control structure. Verifies assets and liabilities by comparing items to documentation

Responsibilities and Duties

• Responsible for replying to and tracking of external audit activity for a variety of payers including Medicare, Medicaid and commercial payers
• Appeals of denied audits
• Conducts internal audits to assure compliance with policy changes driven by Regulatory Requirements
• Developing and providing employee training on compliance policies, practices, and reporting systems
• Identifying, investigating, and reporting compliance issues, irregularities, and violations
• Assist with maintenance of branch records including all regulatory requirements such as licenses, etc.
• Tracking and responding to patient grievances
• Other Projects as required

Minimum Qualifications

Education

Graduate of an accredited high school or GED equivalence.

Experience/Knowledge/Skills/Physical Requirements

• DME Industry experience, preferably in a regulatory capacity
• Analytical skills refer to your ability to break down a problem, gather facts, and find a logical solution.
• Demonstrated ability to use Smartsheet, Microsoft Excel, Word and PowerPoint
• Familiarity with Medicare, State Medicaid and commercial insurance billing and reimbursements as related to DME
• Excellent verbal and written communication and customer relation skills.
• Excellent interpersonal and organizational skills (a team player).