Description
PURPOSE OF THIS POSITION
The purpose of the position is to support the Legal, Risk Management, and Corporate Compliance Department. The Compliance Specialist is responsible for supporting the evolution and preservation of the BVHS's compliance program efforts to prevent, detect and mitigate regulatory risks.
JOB DUTIES/RESPONSIBILITIES
Duty 1: Lead the implementation and coordination of compliance monitoring and auditing processes, including but not limited to, conducting/managing audits, analyzing results, identifying deficiencies, developing reports, and formulating recommendations for corrective action.
Duty 2: Development and implementation of compliance policies and procedures, as needed.
Duty 3: Development and provision of compliance training to employees and other pertinent individuals (i.e. independent contractors, consultants, etc.).
Duty 4: Monitor and audit compliance functions related to billing, coding and medical documentation to ensure that all policies and procedures in the practice adhere to applicable laws, rules and regulations.
Duty 5: Participate in investigations when there are suspected or confirmed instances of non-compliance.
Duty 6: Develop and prepare reports on the status of compliance activities.
Duty 7: Assist with reporting to governmental agencies in accordance with company policies and procedures.
Duty 8: Act as compliance liaison and expert for regulatory inquiries, including but not limited to, responding to inquiries in a timely manner, coordinating responses across multiple departments, as applicable, and conducting follow up on previously submitted responses, if necessary.
Duty 9: Maintains an awareness of current laws, statutes, and regulations that impact healthcare operations.
Duty 10: Participate in the development and implementation of the annual Compliance Program audit plan.
Duty 11: Partners effectively with organizational leaders to monitor compliance risk areas.
Duty 12: Prepare and deliver reports to the all Compliance Committees.
Duty 13: Other duties as assigned to support the Legal, Risk Management, and Corporate Compliance Department.
REQUIRED QUALIFICATIONS
- Bachelor's degree or certification in medical coding and/or risk adjustment (i.e., CPC, CCS, or CCS-P RHIA, RHIT) with 10 years' experience.
- Billing and coding experience.
- Strong attention to detail, analytical, and statistical skills.
- Positive service-oriented interpersonal and communication skills required.
- A valid driver's license is required (if you do not have a valid Ohio driver's license you must obtain one within 30 days of your residency in the state). You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle.
PHYSICAL DEMANDS
Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of materials.
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