Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

OEHC Regulatory Coordinator - Albany.

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Administrative & Support
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EmblemHealth
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Summary of Position
•    Coordinate information and prepare regulatory documentation for submission to regulatory agencies or to commercial partners, advise on the submission strategy. 
•    Ensure timely compilation of materials for license renewals, updates and registrations in coordination with the administrative assistant.
•    Maintain regulatory files/database and chronologies in good order. Establish and maintain system for tracking changes in documents submitted to agencies or partners.
•    Review submissions, files and medical records for compliance with regulatory guidelines in accordance with QA/QC requirements.
•    Support the review of changes to existing procedures to define the requirements for regulatory submissions.
•    Maintain current knowledge of OEHC and Workers Comp regulation, guidance and standards. 
•    Participate in research of regulatory issues and dissemination regulatory information to maintain Quality Assurance under the direction of OEHC leadership.

Principal Accountabilities
•    Ensure timely and efficient completion of submissions to the Workers Compensation Board and other regulatory entities. 
•    Maintain and review documentation of client medical information as part of internal clinical audits in collaboration with the clinical team. 
•    Along with clinical staff, review records documentation for appropriateness and compliance to regulatory requirements and laws.
•    Understand and interpret regulatory requirements; provide guidance on requirements to senior leadership on process improvement and efficiencies.
•    In association with administrative staff and under the guidance of the office manager, scan files, enter data in medical filing systems, produce reports summarizing office visits by clients of the Clinic.
•    Prepare and maintain additional information and data requested by regulatory agencies and with the Medical Director and Office Manager, prepares appropriate responses to such requests.
•    Interface with Department of Health for compliance with Grant contract directly and through the Grants Gateway.
•    Act as a liaison between clinic staff and Occupational Health Network Clinics and the Advisory Board
•    Support the continuing compliance with regulatory requirements as they relate to business and administrative activities of the Article 28 OEHC clinical program.
•    Cross train, monitor and act as back-up for medical receptionists and administrative assistant positions 
•    Maintain corporate confidentiality at all times
•    Perform other duties as required, and develop monthly metric to measure success of processes

Education, Training, Licenses, Certifications
•    Bachelor’s Degree

Relevant Work Experience, Knowledge, Skills, and Abilities
•    3 years’ relevant professional work experience. (R)
•    Knowledge of NYS Department of Health regulations, NYS Worker’s Compensation Program, OSHA regulations, NYS Insurance Programs. (P)
•    Knowledge of medical billing practices. (P)
•    Strong communications skills (verbal, written, presentation, interpersonal). (R)
•    Proficient with MS Office (Word, Excel, Powerpoint, Outlook, Teams). (R)
•    Ability to produce reports accurately and timely. (R)
•    Ability to multitask, organize, prioritize, and complete multiple tasks/assignments with conflicting priorities/deadlines. (R)
•    Knowledge of daily operations and activities of medical clinic. (R)
 

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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