Compliance Specialist - Clinical and Billing

What You’ll Do

• Track, analyze and implement, as appropriate, local, State and Federal laws, rules, regulations and ordinances pertaining to DWP’s clinical lines of business
• Compliance program implementation as it relates to principles, practices and techniques of clinical, billing and coding compliance management
• Effective research techniques utilized in the analysis of organizational compliance
• Policy and procedure development as it relates to DWP’s clinical and billing Compliance Program
• Monitor billing, coding and claims activities to ensure accuracy
• Audit EMR to ensure relevant telehealth guidelines are being met
• Perform continuous risk assessments and report emerging trends, deficiencies and variances, report findings to other departments and teams as appropriate
• Monitoring against regulatory requirements; ensures sufficient monitoring activities to assist with prevention and proactive identification of compliance concerns
• Develops and monitors metrics and other oversight tools that indicate business area compliance
• Provides compliance guidance and direction to assigned business partner
• Conduct quality assurance audits of billing processes to ensure compliance with regulatory requirements, payer policies, and organizational standards
• Develop and maintain quality assurance protocols, and documentation to develop and standardize audit processes
• Develop and implement effective training resources for employees, contractors and vendors

IWP seeks applicants for the position of a Compliance Specialist in its Andover, Massachusetts office.  The Compliance department leads and guides IWP’s efforts to comply with statutory, regulatory, and legal requirements that affect the company.  The Compliance department also manages the company’s internal audit and risk management functions.

What You’ll Need to Succeed

• Bachelor’s Degree or relevant work experience (pharmacy technician, medical assistant or nurse is a plus)
• 2-3 years of experience with regulatory, compliance, telehealth, billing and/or coding experience in healthcare settings preferred
• Compliance Certification (i.e. CHC) preferred or willing to become certified within 12-18 months after hire
• Experience with data privacy and/or HIPAA requirements desired
• MS Office with strong proficiency in Word, PowerPoint and Excel
• Strong writing, editing, and research skills
• Ability to handle compliance matters with sensitivity and confidentiality
• Ability to work independently and as part of a team
• Results oriented
• Strong ethical standards and integrity
• Strong communication skills and appreciation of time sensitivity to deadlines
• Project management skills desired
• Attention to detail
• Ability to work with all levels of management within the organization

Make A Difference With DWP

DWP is the parent company of a portfolio of home delivery pharmacies that specialize in catering to individuals who cannot easily access retail pharmacies due to physical limitations or other predispositions. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you’d like to be part of, we’d love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development.

DWP is an Equal Opportunity Employer.  DWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law.  All employment decisions are made on the basis of qualifications, merit, and business need. HWP is committed to providing reasonable accommodation for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at humanresources@IWPharmacy.com   We will make a determination on your request for reasonable accommodation on a case-by-case basis.