Compliance Specialist – Compliance Department

Full Time Fresno, CA Currently Available

Under general supervision, perform a variety of duties that will support the following: acting as an internal consultant, coordinating audits and investigations, developing training programs, monitoring compliance program key metrics, assisting with risk assessments, and facilitating improvements to departmental systems, software and record keeping.

Qualifications
The requirements listed below are representative of the knowledge, skill, and/or ability required.

KNOWLEDGE AND SKILLS REQUIRED:
Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

  • Maintains a high level of knowledge about healthcare compliance topics and keeps abreast of related regulatory changes. Service as a resource to other departments and internal stakeholders on compliance related matters, with a focus on revenue cycle-related opportunities and issues.
  • Models behavior exemplifying the Corporate Code of Conduct by demonstrating ethical business practices, maintaining confidentiality and demonstrating a high level of support for compliance, quality and risk management efforts.
  • Coordinates activities related to audits and investigations, including maintaining logs, files and preparing correspondence, with a particular focus on compliance program-related issues. Assists with implementing and monitoring of recommended changes and corrective action plans.
  • Coordinates and facilitates required and recommended training. Assesses training needs, and oversees development of presentations. Ensures delivery, tracking, and follow-up related to post-training discussion. Ensures maintenance of records for materials and meetings.
  • Assists to receive key communication (Compliance Hotline, incident reports, written correspondence, emails, and voicemails). Responds as appropriate. Keeps logs, maintains supporting documentation, and prepares reports.
  • Provides for the review and maintenance of departmental policies and procedures related to compliance program. Works with department leaders as needed to ensure that policies and procedures regarding regulatory compliance with medical records documentation, coding, billing, patient accounts, and related internal controls are kept up to date and available.
  • Assists Compliance Manager with other identified compliance matters impacting the organization. Provides expertise and support for compliance program risk assessments.
  • Successfully completes specified goals and objectives for this position, or documents the impediments beyond their control that prevent achievement.
  • Performs other related duties as assigned by the Compliance Manager.Ability to maintain strict confidentiality of employee, patient and company information
  • Ability to maintain and model a high standard of ethics in business operations
  • Ability to communicate effectively; to present ideas and information effectively in front of committees and large groups, with leadership and all workforce members
  • Ability to work effectively with internal and external stakeholders
  • Ability to coordinate and conduct audits and investigations related to revenue cycle, and other compliance matter, and to make recommendations to improve internal efficiencies.
  • Ability to maintain current knowledge of healthcare coding and compliance requirements.
  • Ability to effectively research and report on healthcare regulatory topics related to physician practice/healthcare-related laws and regulations.
  • Ability to maintain current, applicable department policies, records and work papers
  • Ability to manage and monitor progress of work plan activities, prioritize work duties, and be able to complete tasks accurately and within established timeframes
  • Advanced knowledge of healthcare compliance issues and physician practice operations

KNOWLEDGE AND SKILLS PREFERRED:

  • Excellent communication and organizational skills.
  • Must possess the ability to work independently, and in a team environment.
  • Investigations and Auditing skills

EDUCATION AND EXPERIENCE REQUIRED:

  • Degree in business, healthcare, or related field (BA, BSN, MPH, CPA, JD) Within 24 months
  • Minimum of three years documented work experience in healthcare compliance
  • Experience collaborating with and influencing Physicians and Business Executives

EDUCATION AND EXPERIENCE PREFERRED:

  • BSN, MPH, JD or MBA in related discipline, with three years of experience in healthcare compliance, ethics, patient privacy, auditing, regulatory affairs, law, or a combination thereof; or successfully demonstrates specialized knowledge, experience and expertise commensurate with the essential duties and responsibilities of this role.
  • CHC (Health Care Compliance Association Certification), Coding Certification or equivalent

Responsibilities

Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

  • Maintains a high level of knowledge about healthcare compliance topics and keeps abreast of related regulatory changes. Service as a resource to other departments and internal stakeholders on compliance related matters, with a focus on revenue cycle-related opportunities and issues.
  • Models behavior exemplifying the Corporate Code of Conduct by demonstrating ethical business practices, maintaining confidentiality and demonstrating a high level of support for compliance, quality and risk management efforts.
  • Coordinates activities related to audits and investigations, including maintaining logs, files and preparing correspondence, with a particular focus on compliance program-related issues. Assists with implementing and monitoring of recommended changes and corrective action plans.
  • Coordinates and facilitates required and recommended training. Assesses training needs, and oversees development of presentations. Ensures delivery, tracking, and follow-up related to post-training discussion. Ensures maintenance of records for materials and meetings.
  • Assists to receive key communication (Compliance Hotline, incident reports, written correspondence, emails, and voicemails). Responds as appropriate. Keeps logs, maintains supporting documentation, and prepares reports.
  • Provides for the review and maintenance of departmental policies and procedures related to compliance program. Works with department leaders as needed to ensure that policies and procedures regarding regulatory compliance with medical records documentation, coding, billing, patient accounts, and related internal controls are kept up to date and available.
  • Assists Compliance Manager with other identified compliance matters impacting the organization. Provides expertise and support for compliance program risk assessments.
  • Successfully completes specified goals and objectives for this position, or documents the impediments beyond their control that prevent achievement.
  • Performs other related duties as assigned by the Compliance Manager.

Interested candidates should click on the “Apply for this Position” icon below to email your CV for consideration.

Jennifer Haddadin, Recruiter F: Apply For This Position
Compliance Department