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Compliance Officer
2 weeks ago
Duties/Responsibilities:
- Develop and implement policies and procedures that cover all relevant aspects of a medical group compliance program including, but not limited to: fraud, waste and abuse, HIPAA/patient privacy, conflicts of interest, research, Stark, anti-kickback and IT usage.
- Modify policies and procedures as necessary to maintain compliance with federal and state regulations
- Interpret and distribute information on regulatory and compliance manners
- Educate and train employees on all relevant compliance topics
- Enforces disciplinary guidelines to ensure employees continuously and consistently follow standards
- Detect compliance offenses in a timely manner, respond appropriately and implement any corrective action
- Manages internal audits and use of independent third party auditors to ensure compliance with all relevant laws and regulations including billing coding and documentation
- Manages audits by third-party payors, federal and state government agencies
- Functions as HIPAA Privacy Officer to include medical record release process
- Oversees the IT Security Officer or serves in the role if qualified
- Establishes and manages compliance hotline and lines of communication to allow employees to report compliance concerns without retaliation
- Reports compliance status to the Compliance Committee and board of directors on a monthly basis. Reports directly to the board of directors
- Other duties as assigned.
Requirements:
- Minimum 3-5 years healthcare compliance experience
- Strong knowledge of federal and state healthcare compliance laws and regulations, particularly fraud, waste and abuse and privacy
- Demonstrated ability in compliance policy and procedure development, implementation, education and monitoring
- Bachelor’s degree in relevant field, including but not limited to: nursing and other clinical majors, business and healthcare management
- Healthcare compliance certifications preferred
- Excellent leadership, interpersonal, organization and problem-solving skills
Monday-Friday
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