Sr. Compliance Specialist

FreedomCare LLC; United States; Remote; USD 52,000 - 62,000; Full time

Benefits offered by this job

Medical benefits

Retirement plans

Wellness programs

Job summary

FreedomCare LLC is seeking a Sr Compliance Specialist to support the Compliance team in reviewing legal documents, audits, and investigations related to Fraud, Waste & Abuse across our home-care services nationwide.

The role involves conducting audits across jurisdictions, assisting with subpoenas for medical records, and collaborating with Finance on conflicts while upholding Medicaid regulations and background checks. This position emphasizes accuracy, integrity, and cross-state coordination.

Qualifications

• Bachelor’s degree in healthcare with 3+ years in the industry or an Associate degree with 5+ years in healthcare.
• Strong knowledge of Medicaid regulations and screening practices.
• Experience with billing and coding is preferred.

Responsibilities

• Conduct internal and external audits across jurisdictions.
• Assist with conflict reporting and coordinate with finance to resolve conflicts.
• Subpoenas for medical records and general record requests.
• Investigate fraud, waste and abuse claims and propose next steps.
• Be a resource for escalated concerns across active states.
• Quality assurance review and other compliance duties as assigned.

Skills

Healthcare compliance

Audits

Medicaid regulations

Background checks

Billing & Coding (knowledge)

Education

Bachelor’s degree in healthcare

Associate degree

Job description

FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry since 2016. We support our patients by ensuring they have the power to choose a caregiver who will care for them in the comfort of their own homes. Our mission spans coast to coast, supporting patients across the U.S.

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a Sr Compliance Specialist for our Compliance team.

Department & Position Overview:

Our Compliance Team is looking for aSr.Compliance Specialist who can support the compliance department in reviewing legal documents, conducting, and responding to internal/external audits, investigating Fraud, Waste & Abuse claims. The Compliance Specialist role will encompass a wide range of responsibilities that will aid the department inmaintaining regulatory requirements.

Every Day You Will

• Conducting and responding to internal and external audits for alljurisdictions
• Assisting with conflict reporting and collaborating with our finance department to resolve conflicts
• Subpoena of Medical records and general record requests
• Investigating fraud, waste & abuse claims
• Making suggestions on next steps of FWA claims
• Be a resource for escalated concerns for all active states
• Quality assurance review
• All other compliance duties as assigned

Ideal Candidate Will Possess:

• Bachelor’s degree and a minimum of3yearsof experience in the healthcare industryor
• Associate degree and a minimum of 5 years experience in the healthcare industry
• Extensive knowledge ofMedicaidregulations
• Experiencewith Exclusion screening and background checks
• Extensive knowledge of Billing and Coding preferred

Nice-to-Haves:

• Ability to exercise good judgmentin usingknowledge of best practices, regulations, and knowledge of business processes
• Ability toworkwith limited supervision on complex matters; self-starter and takes initiative
• Demonstrated ability to be detail-oriented and thorough
• Reliable and detailoriented.
• Adept at multi-tasking
• Prior experience with internal and external audits

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.

At FreedomCare, base pay is one part of our total compensation package and is determined within a range. This provides our employees with the opportunity to professionally grow and develop within a role. The base pay range for this role is between $25.00 and $28.00 an hour at the commencement of your first year of employment. Compensation decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

Compensation Range

$26—$30 USD