Care Operations & Compliance Coordinator

Role Summary

The Care Operations & Compliance Coordinator helps drive our agency forward by managing day-to-day scheduling, client onboarding, billing accuracy, and regulatory compliance. This is a hands-on, in-office role for someone who loves improving processes, maintaining compliance, and making sure services run smoothly from intake to billing.

STAFF OPERATIONS (Direct Care Staff & Scheduling)

• Manage daily schedules for Direct Care Staff in HHAeXchange
• Ensure client shifts are staffed and covered in real time
• Field calls from caregivers and respond to staffing issues urgently
• Collect and approve weekly timesheets and EVV logs
• Verify alignment between ADP, HHAeXchange, and actual hours worked
• Identify and report EVV compliance issues using HHAeXchange dashboards

CLIENT CARE & INTAKE

• Complete full intake/onboarding for new clients
• Verify program eligibility and gather required documentation
• Communicate services clearly to clients and families
• Serve as a liaison among clients, families, Direct Care Staff, and agency staff

QUALITY ASSURANCE (QA)

• Implement Regal’s QA procedures and documentation standards
• Conduct home visits, calls, and review meetings to monitor service quality
• Audit service notes, incident reports, and required documentation
• Ensure compliance with OLTL regulations
• Maintain files needed for audits, licensing reviews, and record requests

BILLING & CLAIMS OPERATIONS

• Serve as Regal’s primary Medicaid waiver biller
• Submit claims through NaviNet, PROMISe, and HHAeXchange
• Verify service codes, authorizations, and units before billing
• Reconcile inconsistencies between scheduled hours, EVV hours, and billed hours
• Track receivables, denials, and payments from MCOs/state systems

MARKETING & OUTREACH

• Support lead follow-up with clients, families, and referral sources
• Maintain Regal’s social media accounts occasionally (FB/Instagram)
• Assist with email outreach campaigns and community networking
• Conduct meet-and-greets with referral partners (when needed)

PROCESS & SYSTEMS DEVELOPMENT

• Help make every function process-driven and policy-aligned
• Document SOPs and workflow maps for:
• • Scheduling
  • Intake
  • Billing
  • QA
  • Staffing communication
• Help build a culture of training, retraining, and accountability
• Provide support to office operations when needed
• Rarely cover shifts to support emergency client needs

Required Education & Experience

• Associate or Bachelor’s degree in Human Services, Social Work, Nursing, or related field (Preferred)
• 2+ years in home care, human services, or developmental disability services
• 1–2 years Medicaid Waiver billing OLTL using:
• • HHAeXchange
  • NaviNet
  • PROMISe
• Knowledge of person-centered planning and physical disabilities

Required Skills

• Proficiency in Microsoft Excel, Word, and PowerPoint
• Ability to use QuickBooks for invoice tracking or financial entries
• Proficiency in Google Docs/Sheets/Drive
• Knowledge of EVV compliance and state reporting systems
• Strong data accuracy skills for reconciling hours, billing units, and authorizations
• Ability to generate operational and billing reports
• Strong communication skills for working with families, DSPs, and referral sources
• Attention to detail, compliance-driven, and systems-focused
• Valid PA driver’s license and reliable personal vehicle

Compensation & Benefits

• Competitive salary based on experience
• PTO & paid holidays
• Performance-based incentives
• Career development opportunities as our agency grows