COMPLIANCE COORDINATOR


A Chance to Change (ACTC) is seeking a dedicated and proactive Compliance Coordinator to join our dynamic team. This position is responsible for ensuring that clinical consumer documentation complies with all state and federal laws and regulations. This job requires efficiency, time management, and accuracy as consumer files need to be prepared and audited throughout the year. 

This position is also responsible for collaborating with and supporting A Chance to Change (ACTC) Clinical team in paperwork accuracy, time management and efficiency and engaging in teamwork-oriented tasks. This role also serves as the point of contact during audits and corresponds with other entities when providing consumer files as requested.

Essential Duties and Responsibilities

  1. Serve as an active member of the A Chance to Chance team. Includes, but not limited to the following:

  • Have and maintain a professional demeanor and communicate well with all ACTC staff and community partnerships.

  • Attend and be prepared for all relevant agency meetings, including a weekly ops and clinical meeting and a monthly staff meeting.

  • Assist in maintaining a workplace environment conducive to good clinical practice at ACTC and within the community.

  • Reviews all claims in the billing scrub to confirm compliance with documentation requirements and coding validity.

  • Pull contract therapist pay reports according to contract requirements.

  • Produce a monthly claims report and provide it to the Clinical Director (CD) and Chief Executive Officer (CEO)

  • Point of contact for the Oklahoma Department of Mental Health and Substance Abuse (ODMHSA) audits.

  • Updates clinical policies and procedures in collaboration with the CD.

  • Reviews all policies and procedures in relationship to ODMHSA requirement changes.

  • Work with all new ACTC therapists and other clinical staff to create their Oklahoma Health Care Authority (OHCA) accounts and complete Medicaid application, and ODMHSAS PICIS account creation.

  • Produce bi-weekly prior authorization (PA) and treatment plans and Medicaid coverage expiration reports through PICIS

2. Work with ACTC staff to ensure compliance.

  • Communicate and support ACTC therapists to ensure that they are keeping their PICIS entries up to date and accurate. 

  • Ensures that state provider contracts are completed with the Oklahoma Health Care Authority (OHCA) during their orientation period.

  • Provide backup support to ensure that initial PICIS entries for eligible consumers have been entered correctly and in a timely manner.

  • When applicable, correspond with ODMHSAS to ensure the Letter of Termination (LOT) / Letter of Care (LOC) agreements are completed in a timely manner.

  • On a monthly basis, check for PICIS discharge and collaborate with ACTC therapists to complete necessary paperwork before the consumer is automatically discharged from the PICIS system.

3. Electronically audit Medicaid, Gambling and Chemical Dependence consumer files.

  • Check and ensure all required documentation are present and correct. Collaborate with ACTC therapists to ensure all paperwork is submitted and completed appropriately.

  • Communicate with ACTC therapists by sending file corrections to therapists to ensure all files are accurate and ready for external audits.

  • Understand and confirm that files accurately reflect ODMHSAS, Title 43A, and OHCA Prior Authorization standards and regulations.

  • Complete quarterly quality assurance audits and provide results to the Clinical Director (CD) as required by agencies state contract.

Education/Experience: 2+ Years Compliance Experience Required, Bachelor Degree Preferred.

Benefits:

  • 100% Employer Sponsored Medical Coverage available 

  • Dental insurance

  • Vision insurance

  • Employee Assistance Program

  • Simple IRA with up to 3% employer match

  • Flexible Spending Account (FSA)

  • 100% Employer Sponsored Life Insurance

  • Paid time off (4 weeks within the first year)

  • Paid Holidays

Full-Time Position

Interested candidates should submit their resumes to Rachel Whitestar at rwhitestar@achancetochange.org

Call A Chance To Change at (405) 840-9000 for more information