Care Operations & Compliance Coordinator
6 days ago
Bensalem
Job Description Role Summary The Care Operations & Compliance Coordinator helps drive our agency forward by managing day-to-day scheduling, client onboarding, billing accuracy, and regulatory compliance. This is a hands-on, in-office role for someone who loves improving processes, maintaining compliance, and making sure services run smoothly from intake to billing. STAFF OPERATIONS (Direct Care Staff & Scheduling) • Manage daily schedules for Direct Care Staff in HHAeXchange, • Ensure client shifts are staffed and covered in real time, • Field calls from caregivers and respond to staffing issues urgently, • Collect and approve weekly timesheets and EVV logs, • Verify alignment between ADP, HHAeXchange, and actual hours worked, • Identify and report EVV compliance issues using HHAeXchange dashboards CLIENT CARE & INTAKE • Complete full intake/onboarding for new clients, • Verify program eligibility and gather required documentation, • Communicate services clearly to clients and families, • Serve as a liaison among clients, families, Direct Care Staff, and agency staff QUALITY ASSURANCE (QA) • Implement Regal’s QA procedures and documentation standards, • Conduct home visits, calls, and review meetings to monitor service quality, • Audit service notes, incident reports, and required documentation, • Ensure compliance with OLTL regulations, • Maintain files needed for audits, licensing reviews, and record requests BILLING & CLAIMS OPERATIONS • Serve as Regal’s primary Medicaid waiver biller, • Submit claims through NaviNet, PROMISe, and HHAeXchange, • Verify service codes, authorizations, and units before billing, • Reconcile inconsistencies between scheduled hours, EVV hours, and billed hours, • Track receivables, denials, and payments from MCOs/state systems MARKETING & OUTREACH • Support lead follow-up with clients, families, and referral sources, • Maintain Regal’s social media accounts occasionally (FB/Instagram), • Assist with email outreach campaigns and community networking, • Conduct meet-and-greets with referral partners (when needed) PROCESS & SYSTEMS DEVELOPMENT • Help make every function process-driven and policy-aligned, • Document SOPs and workflow maps for:, • Scheduling, • Intake, • Billing, • QA, • Staffing communication, • Help build a culture of training, retraining, and accountability, • Provide support to office operations when needed, • Rarely cover shifts to support emergency client needs Required Education & Experience • Associate or Bachelor’s degree in Human Services, Social Work, Nursing, or related field (Preferred), • 2+ years in home care, human services, or developmental disability services, • 1–2 years Medicaid Waiver billing OLTL using:, • HHAeXchange, • NaviNet, • PROMISe, • Knowledge of person-centered planning and physical disabilities Required Skills • Proficiency in Microsoft Excel, Word, and PowerPoint, • Ability to use QuickBooks for invoice tracking or financial entries, • Proficiency in Google Docs/Sheets/Drive, • Knowledge of EVV compliance and state reporting systems, • Strong data accuracy skills for reconciling hours, billing units, and authorizations, • Ability to generate operational and billing reports, • Strong communication skills for working with families, DSPs, and referral sources, • Attention to detail, compliance-driven, and systems-focused, • Valid PA driver’s license and reliable personal vehicle Compensation & Benefits • Competitive salary based on experience, • PTO & paid holidays, • Performance-based incentives, • Career development opportunities as our agency growsCompany DescriptionRegal Home Health Care is a growing Medicaid-waiver agency based in Bensalem, PA, proudly serving individuals with disabilities across the Philadelphia area. We are dedicated to providing person-centered, community-based support that helps each individual live with dignity, independence, and a fulfilled life.Regal Home Health Care is a growing Medicaid-waiver agency based in Bensalem, PA, proudly serving individuals with disabilities across the Philadelphia area. We are dedicated to providing person-centered, community-based support that helps each individual live with dignity, independence, and a fulfilled life.