Compare your current skills to what this opportunity needs—we'll show you what you already have and what could strengthen your application.
Job Description
Compliance Financial Risk Specialist Vitasya Healthcare Consultants Atlanta, GA Job Details Full-time $55,000 - $70,000 a year 16 hours ago Benefits Health savings account Health insurance Dental insurance 401(k) Paid time off Vision insurance Life insurance Qualifications Insurance third-party billing Accounts receivable Confidential information handling Health insurance policy knowledge Regulatory compliance in claims processing Analysis skills Continuous improvement Attention to detail Medicaid regulations Medicaid Productivity software Insurance claims auditing Analytical thinking Insurance claims fraud prevention Financial data analysis tools Healthcare software applications
Full Job Description Position Overview:
Vitasya Healthcare! The Compliance Financial Risk Specialist is responsible for monitoring and evaluating financial and reimbursement-related risk within the organization. This role supports the agency's Compliance, Risk Management, and Revenue Integrity programs by reviewing claims activity, reimbursement practices, accounts receivable trends, payroll alignment, and client cost share processes to ensure accuracy, regulatory compliance, and financial integrity. The position works collaboratively with operations, payroll, billing, and leadership teams to identify potential compliance risks, recommend corrective actions, and support audit readiness. This is a fully remote position with potential travel for audits, training, or compliance reviews as needed.
Schedule:
Monday-Thursday 9AM to 5PM. Friday's 9AM to 2
PM Structure:
Fully Remote (Some travel
REQUIRED
)
Base Salary:
$55,000 to $70,000 Must live in:
GA, FL, NY, AL, and IN Qualifications/Educational Requirements:
2-4 years of experience in healthcare compliance, revenue cycle, home care billing, auditing, or financial oversight, preferably within home care or home health. Working knowledge of Medicaid, waiver programs, third-party payors, and reimbursement structures. Understanding of fraud, waste, and abuse prevention principles. Strong analytical skills with attention to detail and accuracy. Experience reviewing claims, payment activity, and accounts receivable aging reports. Ability to manage multiple priorities in a remote work environment. Proficiency in Microsoft Office, data analysis tools, and healthcare management systems. Strong written and verbal communication skills. Ability to maintain confidentiality and exercise professional judgment when handling sensitive financial information.
Responsibilities/Essential Functions:
The person in this position must be able to perform the following essential job functions with or without reasonable accommodation. Conduct routine and targeted reviews of home care claims to ensure accuracy, proper authorization, documentation alignment, and regulatory compliance. Monitor reimbursement patterns and identify potential financial or compliance risk trends. Review accounts receivable reports, aging summaries, adjustments, and write-offs for compliance and risk indicators. Evaluate internal practices and system workflows related to claims submission, payment posting, and reconciliation. Review payroll data in alignment with authorized services and submitted claims to ensure consistency and accuracy. Monitor client cost share calculations, application, and documentation for compliance with state and program requirements. Assist in identifying potential fraud, waste, and abuse risks and escalate concerns according to agency policy. Support internal and external audits by preparing documentation, responding to requests, and tracking corrective actions. Collaborate with leadership to develop risk mitigation strategies and process improvements. Prepare summary reports outlining findings, trends, and recommendations for Compliance leadership. Participate in compliance training initiatives and ongoing regulatory education. Maintain strict confidentiality and uphold agency values in all financial review and reporting activities. #VHC1
Pay:
$55,000.00 - $70,000.00 per year
Benefits:
401(k) Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance
Experience:
Healthcare Compliance:
2 years (Preferred)
Auditing:
2 years (Preferred)
Medicaid Waiver Programs:
2 years (Preferred) Willingness to travel: 25% (Required)
