Senior Clinical Compliance Specialist

Innova Solutions has a client that is immediately hiring for Senior Clinical Compliance Specialist Position type: Full-time - Contract to hire Duration: 3 months Location: Philadelphia, PA As Senior Clinical Compliance Specialist, you will be: Responsible for investigating, reviewing, and applying clinical and/or coding expertise in the development and application of medical and reimbursement policies. Responsible for contributing clinical and coding expertise to various initiatives and projects to include medical cost initiatives. Develop and maintain claim payment policies that reflect nationally recognized reimbursement practices in accordance with Company benefit, contracting and reimbursement structures, state and federal mandates and other appropriate sources. Present Claim Payment Policy Bulletins to appropriate workgroups and committees and revise documents according to recommendations. Interact with all levels of associates and management within the Company and with outside contractors, consultants and other organizations. The ideal candidate will have: Bachelor's degree in nursing or equivalent work experience. Licensure required (PA RN license highly preferred). A current coding certification (CCS, CPC, RHIA, RHIT). Minimum of five years related work experience with evidence of a broad base of clinical knowledge and working knowledge of various medical code sets, including CPT, HCPCS, and ICD-10. Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology, and regulatory guidelines. Familiarity with Medicare rules and regulations Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible. Thank you! Sachin Saini 678-207-5262 sachin.saini@innovasolutions.com PAY RANGE AND BENEFITS: Pay Range*: $50- $53 Per hour. *Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc. Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP). ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields. Recent Recognitions: Named One of America’s Best Employers for New Grads by Forbes (2024 Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025) One of the Largest IT Staffing Firms in the US – Ranked 3 by Staffing Industry Analysts (SIA, 2024) One of the Largest Staffing Firms in the US – Ranked 13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics) Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023) One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024) AWS Advanced Tier Services Partner with 100 certifications Website: https://www.innovasolutions.com/ Innova Solutions offers a referral bonus for qualified Ambassadors who refer eligible referrals. Submit referrals at https://innovasolutions.workllama.com/atsuser/anonreferafriend and earn $250-$1,000 per referral Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.aa415a4b-8b21-40fc-a65c-70d2b25ca29a