PCS Compliance Specialist

ALG Senior; Hickory (NC); On-site; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare organization is seeking a PCS Compliance Specialist to assist facilities in managing Personal Care Services assessments and ensure compliance with state guidelines. The ideal candidate will have organizational skills, a background in Microsoft Office, and experience in a fast-paced environment, ensuring effective communication between Medicaid contractors and facilities.

Qualifications

• 2 or more years of equivalent experience preferred.
• Must pass criminal background check.

Responsibilities

• Assist facilities with PCS assessment applications.
• Maintain PCS paperwork standards for compliance.
• Act as a Point of Contact between Medicaid and the facility.

Skills

Strong verbal and written communication

Organizational skills

Analytical skills

Ability to work independently

Microsoft Office Suite

Education

College degree preferred

Job description

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Nature & scope

North Carolina Medicaid reimburses Adult Care Homes for Personal Care Services (PCS). A PCS Compliance Specialist assists facilities with applying for PCS assessment, maintaining PCS paperwork standards to be in compliance with State guidelines, and being a Point of Contact between North Carolina Medicaid’s contractor (Liberty Healthcare) and the facility.

Brief Description

Nature & scope

North Carolina Medicaid reimburses Adult Care Homes for Personal Care Services (PCS). A PCS Compliance Specialist assists facilities with applying for PCS assessment, maintaining PCS paperwork standards to be in compliance with State guidelines, and being a Point of Contact between North Carolina Medicaid’s contractor (Liberty Healthcare) and the facility.

Minimum Eligibility Requirements

• Must have the ability to work independently and with others in a fast paced environment with constant interruptions.
• College degree preferred.
• 2 or more years of equivalent experience preferred.
• Must have prior experience with Microsoft Office Suite (Excel, Word, etc.).
• Must foster a positive, productive work environment.
• Must exhibit strong verbal and written communication skills.
• Must be honest, fair, dependable, respect confidentiality and the rights and privacy of others.
• Must practice and promote Meridian Policies and Procedures, Mission Statement, Core Values, and Founding Principles.
• Must have excellent organizational and analytical skills and the ability to take on multiple tasks.
• Must be able to learn new skills quickly and implement these skills thoroughly and properly.
• Must be able to perform duties and responsibilities (essential job functions), with or without reasonable accommodation.
• Must pass criminal background check.
  
  

Essential Functions

• Reviewing Medicaid admissions
• Creating PCS requests for new Medicaid residents
• Following up with facilities regarding outstanding PCS requests
• Reviewing PCS requests and submitting them to Liberty Healthcare
• Scheduling PCS Assessments on behalf of facilities
• Following up with Liberty Healthcare regarding outstanding PCS assessments
• Logging awarded PCS hours in MyCensus
• Accepting awarded PCS hours in QiReport
• Updating a shared Excel Report with PCS team
  
  

Job Specifications

• Ability to work with confidential information.
• Well organized and confident to work independently, but will be a team player.
• Demonstrate initiative and thoroughness in researching and resolving issues.
• Accurate with data keying.
• Detail- and deadline-oriented with the ability to prioritize and multi-task.
• Ability to adapt to a fast-paced environment and learn and retain new or evolving information and procedures.
• Utilize good communication skills with internal team and external vendors.
• Flexible and responsive to changing business needs.
  
  

Physical/sensory requirement

• Sedentary Work: ability to exert 10 pounds of force occasionally, and/or negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.
• Maintains professional business attire.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Hospitals and Health Care

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