Health System Specialist

1 month ago


Chicago, Illinois, United States Veterans Health Administration Full time

MAJOR DUTIES:

  • Performs functions associated with the initial and continued development and oversight of the
facility Integrity and Compliance Program

  • Collaborates with the facility Integrity and Compliance Officer (ICO) in planning, developing, and
implementing programs to effectively identify, plan, assess, respond, and monitor areas of high
risk, and coordinate efforts to improve performance as deemed necessary while performing
VHA and other mandated audits and reviews of compliance program areas.

  • Provide audits and analyses of data entered into clinical systems, including but not limited to
CPT codes, encounter documentation, enrollment data, means testing and workload

  • Provides educational assistance to facility staff under the direction of the Integrity and
Compliance Officer.

  • Developing and reviewing procedures and methodologies to ensure accuracy of
reimbursement, insurance information, enrollment reliability and other compliance related
data,

  • Providing answers to difficult technical questions regarding coding and analysis and
resolve coding discrepancies.

  • Providing feedback to physicians and staff concerning medical record documentation
  • Serving as technical advisor and resource person and/or liaison with the medical staff on
questions relating to medical record documentation, coding, enrollment, insurance,
means testing and reimbursement issues

  • Compiles and maintains appropriate management reports and committee minutes
  • Assists in maintaining good communications between the OIC Office and VA staff
  • Provides technical assistance to the ICO in the selection of focused audits, criteria
development, data retrieval, compilation of findings, and follow-up audits oriented toward
improved utilization of resources including cost effectiveness

  • Continues education to keep abreast of new developments and policy changes that
affect the Integrity and Compliance Program and recommends revisions of the technical
aspects of these programs to meet these new demands.

  • Provides staff support to the Integrity and Compliance Committee and Command Suite.
  • Participates in discussions, develops agenda content for recurring meetings and
prepares meeting minutes.

  • Creates communication processes and tools that are flexible, customizable, and
interactive to address the health care system's unique compliance challenges and
education/training needs.

Work Schedule:
Monday-Friday 7:00am -3:30pm

Telework:

VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies.

This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Position Description/PD#:
Health System Specialist (Integrity and Compliance Auditor)/PD06379O

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