Compliance Specialist | Compliance | FT

Overview
Since the doors opened more than 59 years ago, UF Health Leesburg Hospital has continued to build upon its reputation as a leading medical center and the most comprehensive provider of health care services in the region. The hospital offers advanced cardiovascular care, including one of the largest open-heart programs in Florida. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating patients with chest pain by awarding a Chest Pain Center Accreditation with Primacy PCI and Resuscitation - its highest and best level of accreditation. The hospital also offers world-class orthopedics, minimally invasive robotic surgery, life-saving emergency care, stroke treatment, labor & delivery, and so much more.
Responsibilities
The Compliance Specialist will serve as an integral member of the Compliance Department and report to the UF Health Central Florida Director of Compliance. The Compliance Specialist will provide ongoing compliance monitoring and auditing functions 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
Education

• Bachelor's Degree in a health, education, or business-related field with 2 years' work experience in clinical, coding, auditing, legal, clinical research or related field, OR
• Associate's degree with 4 years' work experience in above stated fields, OR
• Associate's degree with certifications in Compliance, coding and/or auditing AND 6 years' work experience in above stated fields, OR
• Advanced Degree (e.g. Juris Doctorate) with knowledge of and experience with healthcare statues and regulations that govern hospitals and/or the health care industry

Licensure/Certification/Registration

• RN, LPN, RHIA or RHIT, CPC-H/COC, CPC, CCS, CHC/CHRC preferred
• Must obtain Certification in Healthcare Compliance (CHC) or Certification in Healthcare Research Compliance (CHRC), as applicable, within 18 months of hire or transfer into the department
• Additional certifications may be required to support or enhance departmental expertise (e.g. Certified Professional Coder (CPC) or Certified Outpatient Coder (COC))

Special Skills/Qualifications/Additional Training/Experience Required

• Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred
• Must be knowledgeable of state and federal statutes and regulations governing the healthcare industry
• Ability to research and understand complex regulations is required
• Proven ability to solve problems is essential
• Intermediate skills with MS Office tools (including Excel, Word, and Power Point) is required
• Must be organized, versatile, and able to work independently
• Must be able to read, write, speak and understand English