Compliance Specialists

by  Jared Staheli, MPP
Sep 9th, 2014 - Reviewed/Updated May 14th

Compliance specialists are responsible for monitoring health and human services program operations for compliance with federal and state regulations and standards in order to promote health and safety, assure that public services are delivered properly, or prevent fraud. Areas assessed may include service delivery, eligibility determination and payment, medical reimbursement, risk and safety, or operational practices. Responsibilities range from entry level professional to management.

There are different types of compliance specialist certifications available.  Here are just a few examples:

• MCS-P (Medical Compliance Specialist - Physician)
• CPCO (Certifed Professional Compliance Officer)
• CHC (Certified in HealthCare Compliance)
• CPMA (Certified Professional Medical Auditor)
• CMCO (Certified Medical Compliance Officer)