Junior Billing Compliance Coordinator

Jewish Board; New York (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

The Jewish Board is seeking a Junior Billing Compliance Auditor in New York to support billing compliance across agency divisions. You will coordinate with senior specialists, maintain audit records, and help ensure adherence to fraud, waste, and abuse controls.

The role requires BA/BS, experience with audits, and strong communication. You will collaborate with program staff and leadership to drive timely, accurate compliance actions and support regulatory reviews.

Qualifications

• BA/BS required. MS/MA/MBA/MPA/LCSW/LMSW preferred.
• Experience in Behavioral Health, CASAC, Public Health, Public Administration, Social Work.
• Experience with regulators OCFS, OMH, OPWDD, OMIG, OASAS, DOHMH, NYS DOH, ACS.
• One year auditing experience preferred.
• Strong interpersonal and verbal communication skills; ability to engage staff at all levels.
• Project management and organizational skills; ability to work independently.

Responsibilities

• Remain up-to-date and knowledgeable of regulatory and guidance requirements.
• Conduct internal billing/claims audits agency wide.
• Maintain a matrix of regulatory updates division wide.
• Lead or participate in investigations of fraud, waste, and abuse of public funds.
• Respond to alleged violations, evaluate complaints and/or initiate inquiry with supervisor.
• Work collaboratively with program staff and other departments to mitigate exposure.

Skills

Regulatory interpretation

Engagement skills

Communication skills

Analytical skills

Multitasking

Education

BA/BS required

MS/MA/MBA/MPA/LCSW/LMSW preferred

Tools

Microsoft Office

Job description

For nearly 150 years, The Jewish Board has been delivering innovative, best-in-class mental and behavioral health services. We are unique in serving everyone from infants and their families, to children, teens, and adults. That adds up to countless opportunities to use your skills, training, and compassion to make a difference in the lives of over 45,000 New Yorkers each year.

The Corporate Compliance department supports the agency in maintaining compliance in all areas of operations. The department focuses on promoting a culture of compliance, preventing, and detecting fraud, waste, and abuse, and educating staff on their rights to report suspected non-compliance. The Junior Billing Compliance Auditor is responsible for supporting The Corporate Compliance Program within one or more of the agency divisions of service to ensure billing compliance requirements are being met. The Junior Billing Compliance Auditor under the Director of Corporate Compliance for billing will coordinate with senior compliance specialists, management, and staff to ensure that the Jewish Board achieves consistently high levels of compliance with all applicable billing laws and regulations; policies and procedures and the code of conduct and will respond to any matter in a timely manner.

Key Essential Functions

• Remain up-to-date and knowledgeable of all regulatory and guidance requirements.
• Conduct internal billing/claims audits agency wide.
• Participates and assist in coordinating Compliance Review Committee (CRC) meetings.
• Maintaining a matrix of regulatory updates division wide.
• Act as an independent auditor by reviewing compliance of all departmental procedures, policies, and practices to ensure compliance with agency requirements that mirror billing audits conducted by OMIG, CMS, 3rd party vendors, and MMCO’s.
• Maintain the recording hub of audits including report findings and performance improvement plans within a designated division of service.
• Identify areas of potential exposure and risk. Assist in the development of corrective action plans for the resolution of any risk issue and ensure implementation of same.
• Lead or participate in investigations of fraud, waste, and abuse of public funds.
• Respond to alleged violations of rules, regulations, and policies, et. al., evaluate complaints and/or recommend the initiation of any inquiry to their supervisor.
• Work collaboratively with program staff, and other support departments to address and mitigate identified areas of exposure.
• Coordinates the completion of regulatory mandated projects and supports the use of regulatory systems, organizing training activities as needed.
• Conduct trainings to staff around compliance needs, regulations and issues including facilitation of the Compliance piece of the agency.
• Participate in the agency wide accreditation preparation process and actual survey.
• Sustain an environment that fosters team member engagement, equity, inclusion and belonging. Establishes clear objectives tied to department and/or organizational strategic goals.
• Other duties as needed.

Additional Functions May Include

• Special projects as assigned by agency leadership.

CORE COMPETENCIES for the position include

• Strong ability to independently research, read, and accurately interpret complex regulatory materials such as state and federal regulations and guidance memos and apply the information to auditing activities.
• Engagement skills. Demonstrate and model effective engagement skills in all areas of interaction.
• Strong verbal and written communication skills; relative to implementation and interpretation policy and procedures within the corporate compliance arena
• Strong analytical skills to determine citation trends within potential risks
• Able to operate in a fast-paced work environment while effectively handling multiple and varied tasks with a clear focus on detail, productivity, and quality outcomes.
• Ability to maintain quality performance while working autonomously and collaboratively with both internal and external teams.

Educational / Training Required

• BA/BS required. MS/MA/MBA/MPA/LCSW/LMSW preferred.
• Experience in related fields (i.e., Behavioral Health, CASAC, Public Health, Public Administration, Social Work)
• Experience with state regulators including but not limited to, OCFS, OMH, OPWDD, OMIG, OASAS, DOHMH, NYS DOH, and ACS.
• One year auditing experience preferred.
• Strong interpersonal and verbal communication skills, ability to engage staff at all levels of responsibility.
• Project management and organizational skill along with an ability to work independently is necessary.
• Experience in a not-for-profit or social service setting.
• Prior experience in interpretation of regulation and/or policy development and implementation preferred.
• Excellent organizational, time management, written and verbal communication skills.
• Proven analytical and problem-solving skills.
• Ability to attend agency meetings, held during business hours.
• Certification in Lean Six Sigma preferred.

Computer Skills Required

• Knowledge of personal computers, standard software, and database management.
• Intermediate proficiency in Microsoft Office Suite.
• Ability to quickly adapt to agency computer applications.

Communication Skills

• Ability to articulate the agency’s philosophy, mission, and goals to a varied audience.
• Ability to interview a variety of managers, employees, consumers, and their families.
• Ability to write reports, business correspondence and procedures for a wide audience.
• Ability to lead ad-hoc task forces and meetings, which may include all levels of management and employees.
• Ability to respond to inquiries or complaints, including those of a sensitive and confidential nature, from any of the following, if applicable, under a variety of circumstances, including adversarial situations: consumers, managers, employees, regulatory agencies, arbitrators, union representatives, vendors, or applicants.
• Ability to effectively present information to consumers, top management, and staff in verbal and written formats.
• Ability to recognize the need for confidentiality of information and to maintain such confidences.

Work Environment / Physical Effort

• Noise level is consistent with levels usually present in an office, education, rehabilitation, industrial, workshop or health related environment.
• Hazards present are consistent with those common to an office, education, rehabilitation, industrial, workshop or health related environment.

Visual and Manual Dexierity

• The candidate should be able to read documents for analytical purposes such as computer information, software, computer graphic design programs, etc.
• Limited applications of manual dexterity and hand-eye coordination.

The Jewish Board delivers innovative, high-quality, and compassionate mental health and social services to over 45,000 New Yorkers each year. We are unique in serving everyone from infants and their families to children, teens, and adults. We are proud to employ and serve people of all religions, races, cultural backgrounds, gender expressions, and sexual orientations. We are committed to building diverse, equitable, and inclusive teams to help support our mission, and we strongly encourage candidates from historically marginalized backgrounds to apply to work with us.

Our Values.

Our values help guide us in everything we do, from our relationships with fellow staff to the clients and communities we serve.

Treat every person
with dignity

We act with respect and caring towards our clients, colleagues, and communities.

Strive to
be outstanding

We are exceptional professionals in all that we do.

Embrace each
other’s differences

We create a fair and inclusive environment for all.

Engage individuals and families
as our partners

We heal our communities one person at a time through thoughtful collaboration.

We respect diversity and accordingly are an equal opportunity employer that does not discriminate on the basis of race, color, creed, religion, national origin, alienage, citizenship status, age, disability, sex, gender, gender identity or expression (including transgender status), sexual orientation, marital status, partnership status, veteran status, genetic information, or any other status protected by applicable federal, state, or local law.

This applies with respect to recruiting, hiring, placement, promotion, transfer, training, compensation, termination, assignments, benefits, employee activities, access to facilities and programs, and all other terms and condition of employment as well as general treatment during employment.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of qualified employees with disabilities, without regard to any protected classifications, unless the accommodation would impose an undue hardship on the operation of our business. Any employees who need assistance to perform their job duties because of a physical or mental condition should contact human resources.

We respect diversity and accordingly are an equal opportunity employer that does not discriminate on the basis of race, color, creed, religion, national origin, alienage, citizenship status, age, disability, sex, gender, gender identity or expression (including transgender status), sexual orientation, marital status, partnership status, veteran status, genetic information, or any other status protected by applicable federal, state, or local law.

This applies with respect to recruiting, hiring, placement, promotion, transfer, training, compensation, termination, assignments, benefits, employee activities, access to facilities and programs, and all other terms and condition of employment as well as general treatment during employment.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of qualified employees with disabilities, without regard to any protected classifications, unless the accommodation would impose an undue hardship on the operation of our business. Any employees who need assistance to perform their job duties because of a physical or mental condition should contact human resources.