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ADH HIPAA PROGRAM CONSULTANT

The Health Insurance Portability and Accountability Act (HIPAA) Program Consultant is responsible for ensuring the confidentiality and integrity of electronic health insurance information for

Class Code:

L014C

Job Grade:

GS10

Special Job Requirements:

0

Typical Functions:

Provides general supervision of the work of subordinate employees by prioritizing work assignments, establishing deadlines, providing general instructions, and reviewing the work performed to ensure technical accuracy and compliance with instructions or established policies and procedures. Reviews Certificate of Non-Coverage applications for the correct information and approves or rejects application. Oversees the processing of approved and rejected applications, and approves, signs, and seals all approved Certificates of Non-Coverage. Assists the general public and insurance industry in the resolution of compliance, coverage, and Certificates of Non-Coverage problems. Investigates employers to determine violation of compliance laws and notifies employers of non-compliance. Prepares compliance cases to be presented to the Adjudication Division and presents testimony in Adjudication hearings. Performs other duties as assigned.

Knowledge, Abilities, and Skills:

Knowledge of supervisory practices and procedures. Knowledge of HIPAA law and regulations. Knowledge of Workers’ Compensation law, coverage requirements, and reporting procedures. Knowledge of manual and automated record keeping systems, practices, and procedures. Ability to investigate, analyze, and evaluate information and recommend appropriate action. Ability to plan, organize, and oversee the work of subordinates. Ability to prepare and present oral and written information and reports.

Minimum Qualifications:

The formal education equivalent of a bachelor’s degree in public administration, healthcare administration, business administration or a related field; plus five years of experience in insurance investigation or compliance operations, including two years in a supervisory capacity.

Required Certificates:

0

Exempt:

E
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