Healthcare regulatory and compliance paralegal

Come join an exciting and innovative company that puts the “care” back in healthcare!
Join us and find out why this is the place to excel and do your best work.

What started as a single pharmacy in 2010 has grown into KabaFusion becoming the largest privately held home infusion company in the country. We have a national network of pharmacies and nursing offices strategically placed to service 40+ states. Couple that with over 30 years of combined experience and it’s no wonder why KabaFusion is the industry leader in home infusion.
Interpreting applications for Medicare and Medicaid, compiling supporting documents and analyzing the various requests prior to submitting these applications as well as fulfilling corporate filing functions. Responsible for monitoring, and providing support on a variety of complex federal, state, county and city regulatory licensing, compliance policies and procedures for the healthcare industry. Responsible for updating the maintenance filings to keep Medicare and Medicaid enrollments and associated permits active, and to ensure the timely submission of renewal forms and supporting documentation to regulatory agencies to guarantee revalidations. Oversight of the maintenance of pharmacy profiles on NCPDP and NPI websites.
Medicare and Medicaid applications:
Conduct research on the full nature of the application process for each entity and state.
Maintain and update the research to remain in compliance year to year.
Interpret and analyze the requirements of each application.
Compile the necessary supporting documents for each application.
Support Medicare and Medicaid line of business for upcoming contract year business readiness
Spearhead submission of Medicare/Medicaid Applications.
Assist in the development, implementation, and maintenance of annual timelines/work plans using contracting software to ensure timely and successful project completion including ad hoc projects.
Responsible for staying up to date with the latest communications and guidance provided by CMS as it relates to applicable projects.
Coordinate cross-departmental informational updates with Licensing, Managed Care and Reimbursement Teams – focusing on teamwork, information flow and supporting data to promote cross-training and unified team direction.
Research special license projects and provide upper management with a comprehensive report outlining requirements, forms, application, regulations, timelines, fees, etc.
Complete and file Medicare 855S DMEPOS and 885B HIT applications 16. Ensure enrollment processes are compliant with payer requirements for Government Health Plans
Oversee the initial set up of user accounts with Government, Commercial Health Plans and Medical Group payer portals based on job function.

to the NCPDP and NPI websites
Manage and submit ownership and disciplinary action disclosures as required for new/renewed credentialing and licensing applications.
Basic knowledge of business compliance regulatory framework

• Knowledge in all aspects of healthcare industry federal, state, county and city rules and regulations pertaining to the operations of home infusion pharmacies and home health agencies.
• Excellent writing skills, ability to communicate effectively with branch managers and governmental agencies processing personnel.
• Demonstrated ability to work with minimal supervision
• Ability to serve as a liaison with key internal stakeholders, Pharmacists in Charge, Nursing Administrators and Directors of Nursing, attorneys, and external organizations
• Continuously monitors changes and evaluates specific activities that may have an impact on the current licenses: including but not limited to relocations, change of ownership, company name changes, DBA's, and changes of Pharmacist in Charge, Nursing Administrators and Directors of Nursing. Proficient with computer applications, such as Windows, Excel and Word.

• Paralegal certificate required • Bachelor's Degree preferred.
• At least 1+regulatory compliance and/or credentialing experience preferred

• Company paid life insurance, short term disability
• Employee Assistance programs to help with mental health / wellness
• Perks… includes discounts on travel, cell phone, clothing and more…
• Join us and find out why this is the place to excel and do your best work.