Compliance Specialist - Clinical and Billing

DescriptionDWP seeks applicants for the position of a Compliance Specialist in its Andover, Massachusetts office. The Compliance department leads and guides DWP's efforts to comply with statutory and regulatory requirements that affect the company. The Compliance department also manages the company's audit and risk management functions.What You'll DoTrack, analyze and implement, as appropriate, local, State and Federal laws, rules, regulations and ordinances pertaining to DWP's clinical lines of businessCompliance program implementation as it relates to principles, practices and techniques of clinical, billing and coding compliance managementEffective research techniques utilized in the analysis of organizational compliancePolicy and procedure development as it relates to DWP's clinical and billing Compliance ProgramMonitor billing, coding and claims activities to ensure accuracyAudit EMR to ensure relevant telehealth guidelines are being metPerform continuous risk assessments and report emerging trends, deficiencies and variances, report findings to other departments and teams as appropriateMonitoring against regulatory requirements; ensures sufficient monitoring activities to assist with prevention and proactive identification of compliance concernsDevelops and monitors metrics and other oversight tools that indicate business area complianceProvides compliance guidance and direction to assigned business partnerConduct quality assurance audits of billing processes to ensure compliance with regulatory requirements, payer policies, and organizational standardsDevelop and maintain quality assurance protocols, and documentation to develop and standardize audit processesDevelop and implement effective training resources for employees, contractors and vendorsDWP seeks applicants for the position of a Compliance Specialist in its Andover, Massachusetts office. The Compliance department leads and guides DWP'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 SucceedBachelor'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 preferredCompliance Certification (i.e. CHC) preferred or willing to become certified within 12-18 months after hireExperience with data privacy and/or HIPAA requirements desiredMS Office with strong proficiency in Word, PowerPoint and ExcelStrong writing, editing, and research skillsAbility to handle compliance matters with sensitivity and confidentialityAbility to work independently and as part of a teamResults orientedStrong ethical standards and integrityStrong communication skills and appreciation of time sensitivity to deadlinesProject management skills desiredAttention to detailAbility to work with all levels of management within the organizationMake A Difference With DWPDWP 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@ We will make a determination on your request for reasonable accommodation on a case-by-case basis.

Created: 2025-02-19