Compliance Specialist | Compliance | Days | Full Time

Overview
To provide ongoing compliance monitoring and auditing functions for a multi-hospital healthcare system to include review of regulatory, audit, billing, coding, documentation, medical necessity and other general compliance processes and analyses that result in appropriate reimbursement for the hospital and adherence to applicable laws, rules, guidelines and regulations. Provides ongoing compliance education and training. Researches and responds to compliance inquiries. Follows investigation protocols and responds to reported, suspected, or confirmed non-compliance. Participates in and attends compliance meetings that foster open lines of communication within the organization. Assists in the development and monitoring of special compliance projects with Compliance Managers and members of hospital departments. Provides compliance advice and guidance.
Qualifications
Minimum Education and Experience Requirements: Bachelor's degree and 2 years compliance, clinical, coding, auditing, legal, or related work experience; OR Associate's degree in a health or business-related field and 4 years compliance, clinical, coding, auditing, legal, or related work experience; OR certifications in Compliance, Coding and/or Auditing, and 6 years compliance, clinical, coding, auditing, legal, or related work experience with knowledge of and experience with healthcare laws and regulations that govern hospitals and/or the health care industry. CHC (Certified in Healthcare Compliance) credential is preferred. RN, LPN, RHIA, RHIT, CPC-H/COC, CPC, or CCS preferred. Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred. Must be knowledgeable of Medicare, Medicaid, state and federal laws and regulations governing the healthcare industry. Ability to research and understand complex regulations is required. Proven ability to problem-solve is essential. Skill with MS Office tools (including Excel, Word, and Power Point) is required. Must be organized, versatile, and able to work independently. Motor Vehicle Operator Designation: Employees in this position: Will operate vehicles for an assigned business purpose as a • non-frequent driver• Licensure/Certification/Registration: Certification in Healthcare Compliance (CHC) can be obtained within 12 months of hire or transfer into the department.