Regulatory Affairs & Compliance Assistant
Assist in management of the company’s state regulatory licensure filings (TPA, UR, PPO, Agent and Agency Licensures). Prepare external and internal audits. Records management. Corporate and HIPAA compliance staff training. Research and monitor state and federal regulations regarding HIPAA, managed healthcare, Medicaid and Medicare as well as state mandated licensing requirements. Contract management. Assist with development/updating corporate compliance policies.Administrative Assistant Operations: Provide administrative and staff support to all Operations departments by administering programs, projects, and/or processes specific to the operating units served. Assist HR Generalist with payroll and timecard management, new hire orientation and training as well as other administrative functions requested by HR Generalist. Manage appointments and travel arrangements for senior/executive level staff. Develop and implement company events. Manage vendor show participation and marketing. Prepare and coordinate records, statistics and reports regarding Operations. Serve as administrative liaison regarding issues related to purchasing, facilities, and operations.Customer Solutions Network Management: Provide high level, comprehensive problem resolution to members and providers by managing expectations and resolving customer concerns. Educate providers on company policies and procedures. Assist members with securing services from participating providers and understanding EOB and payment responsibilities. Serve as knowledge-leader for external and internal customers.Network Management Specialist: Develop provider network for vision insurance plans nationwide. Negotiating contracts within set parameters. Provide education and problem resolution to providers. Administrative support in provider contract management, loading participating providers onto website for claims filing. Represent organization at National Optometry/Ophthalmology Marketing Conferences.
