The Initial Reviewer-Compliance Support reviews, evaluates, and performs fulfillment of the various document requests made by internal and external stakeholders. This position is responsible for completing requests in accordance with pre-established deadlines and multitasking when deadline with numerous requests of varying complexity.
Essential Job Duties:
•Complete the examination of all forms and requested documentation in accordance with established procedures and program rules for requests that are complex in nature and/or have a significant financial relevance.
•Understand, interpret, determine, and document request types using defined operating guidelines.
•Document findings and prepare audit files. Writes detailed reports.
•Conducts a quality review of all assigned program documentation to ensure work is completed accurately and according to program guidelines.
•Perform other duties as assigned.
Education and Experience Requirements:
•High School diploma or GED required
•Proficient in the use of Microsoft Office products
•Ability to analyze and solve problems that vary from established procedures and make sound decisions.
•Must be a quick learner, have the flexibility and desire to learn and perform a variety of tasks for multiple programs, and be open to suggestions.
•Ability to prioritize, meet deadlines, and work independently.
•Ability to manage multiple assignments including following through and keeping focused in a dynamic work environment.
•Strong organization, teamwork, interpersonal, math, and research skills.
•Strong verbal and written communication skills are critical when responding to inquiries.
•Strong customer focus with ability to maintain customer rapport.
•Ability to understand, analyze and interpret complex related documents including technology plans, business and technology equipment, and related information.
•Able to work in a fast paced environment with focus on productivity and accuracy
Additional Requirements as per Contract/Client:
•Must be a US Citizen
Essential Duties and Responsibilities:
- Research and resolve discrepancies with provider documents.
- Review information keyed into the system to verify the accuracy of data.
- Monitor data/image quality of scanned documents.
- Follow established policies and procedures for index and imaging without deviation.
- Maintain confidentiality and security of relevant information.
- High School diploma or equivalent with 0 - 2 years of experience.