Overview
Legal Secretary Jobs in Las Vegas, NV at Testan Law
About Us
All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 410k plan. Additional employee paid coverage options available.
Job purpose
The Audit Manager is responsible for managing All Care To You’s audits including but not limited to Claims audits, UM/CCM audits, and Global/HIPAA audits. The Audit Manager oversees the audit process from start to finish to ensure audit deliverables are submitted in a timely manner and audits are conducted with the highest standards of quality and accuracy.
Duties and responsibilities
· Responsible for overseeing claims, utilization management, and general compliance audits including but not limited to:
o Delegating file preparation to the Compliance Coordinators
o Reviewing files for inconsistencies, quality assurance, and proactive identification of errors and remediation response
o Ensures audit deliverables are submitted in their entirety and timely.
o Coordinates with Compliance Officer and other department heads on audit results and Corrective Action Plans as applicable.
· Conducts Claims and UM Source System Validations with health plan partners. Leads initiatives to address and resolve findings from SSV if any. Implement and monitor corrective actions to ensure continuous process improvement
· Responsible for training and overseeing future Compliance Coordinator in the preparing of claims, utilization management, and general compliance files.
· Develop, initiate, maintain, and revise compliance policies and procedures and job aids regarding audits and the internal workflow as it pertains to audits.
· Notifies Compliance upper management regarding any compliance issues for investigation and resolution.
· Coordinate with healthcare information technology team on audit universe generation and any deficiencies identified internally or externally by auditors
· Coordinate compliance activities with other departments and sources as necessary.
· Maintain Compliance email, communication with health plans regarding audits, audit related deliverables, and audit related deadlines.
· Assist and coordinate ACTY’s response to audits by coordinating with claims and care management teams to assure that appropriate actions are taken to resolve any problems.
· Assist with the development of Corrective Action Plans (CAPs) for regulatory agencies.
· Coordinate Compliance audit related deliverables with Compliance Project Manager as needed to ensure timely and quality completion
· Perform other related duties as assigned.
Qualifications
· Bachelor’s Degree, relevant experience in lieu of degree
· 2 years’ experience within in a healthcare administration organization
· Ability to work independently as well as contribute to a positive team atmosphere
· Authorization and Claim processing understanding preferred.
· EZ-Cap experience preferred
· Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe
· Detail oriented and highly organized
· Strong ability to multi-task, project management, and work in a fast-paced environment
· Strong ability in problem-solving
· Ability to self-manage, strong time management skills
· Ability to work in an extremely confidential environment
· Strong written and verbal communication skills
Job Type: Full-time
Pay: $55,000.00 – $85,000.00 per year
Benefits:
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Life insurance
Vision insurance
Work from home
Schedule:
8 hour shift
Monday to Friday
Work Location: Remote
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Title: Legal Secretary
Company: Testan Law
Location: Las Vegas, NV
