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Compliance Specialist The candidate will provide ongoing monitoring and auditing functions for a multi-hospital healthcare system to include review of regulatory, billing, coding and documentation accuracy. Provides an overview of compliance program activities and requirements via ongoing education and training. 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. Must have Bachelor's degree in a health, education, or business-related field and 2+ years clinical, coding, auditing, legal, clinical research, or related work experience Or Associate's degree in a health or business-related field and 4 years clinical, coding, auditing, legal, clinical research, or related work experience Or certifications in Compliance, Coding and/or Auditing, and 6 years clinical, coding, auditing, legal, clinical research, or related work experience Or Advanced degree (e.g. Juris Doctorate) with knowledge of and experience with healthcare statutes and regulations that govern hospitals and/or the health care industry. RN, LPN, RHIA or RHIT, CPC-H/COC, CPC, CCS, CHC/CHRC is preferred. Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background is desired. Must be knowledgeable of state and federal statutes and regulations governing the healthcare industry. Intermediate skill with MS Office tools (including Excel, Word, and Power Point) is required.
Job ID: 51533
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