Compliance Specialist

6 days ago

Greenwood Village, United States CommonSpirit Full time
Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

JOB SUMMARY / PURPOSE
Supports the Corporate Responsibility Program (CRP) by developing, implementing, and maintaining an effective and comprehensive compliance monitoring program. Conducts and facilitates monitoring activities across CommonSpirit Health and analyzes outcomes, communicates findings, and ensures follow-up on action plans as appropriate. Operates in an independent and objective manner and maintains a high level of competency related to compliance with State and Federal laws and regulations.

ESSENTIAL KEY JOB RESPONSIBILITIES
  • Supports the development, implementation, maintenance, completion and reporting of the annual CRP Monitoring Plan.
  • Performs compliance monitoring as required to identify education opportunities and areas of potential risk. Monitoring may include but is not limited to coding, medical documentation, privacy and general CRP compliance.
  • Determines monitoring procedures to be used, including the use of computer-assisted audit techniques.
  • Obtains, analyzes, and appraises evidentiary information as a basis for determining the adequacy and effectiveness of internal compliance controls.
  • Provides education to departments regarding audit findings, reimbursement impact, identified compliance issues and risk mitigation, and recommends changes to improve processes, strengthen controls, and promote compliance.
  • Prepares and presents monitoring reports and works with management to develop corrective action plans.
  • Keeps management informed of any significant findings detected during an audit or monitoring project.
  • In collaboration with Corporate Responsibility Officers, assists with tracking follow up with operations on development, implementation and completion of action plans.
  • Maintains monitoring statistics for tracking and trending purposes.
  • Conducts reviews to include physician payments, business associate agreements, lease agreements, etc.
  • Participates in the Physician Transaction contracting process as assigned
  • Participates in divestiture and acquisition projects as applicable
Qualifications

Required Education and Experience
  • Bachelor's degree - equivalent education/experience may be considered in lieu of degree.
  • Minimum 3 years of experience in contracts auditing and monitoring.
Required Licensure and Certifications
  • One of the following is preferred upon hire or required within first year of employment: Certification in Healthcare Compliance (CHC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Health Professional (CHP), Certified Coding Specialist - Physician-based (CCS-P), Certified Coding Specialist
    (CCS), Certified Prof. Coder through AAPC (CPC), Certified Public Accountant (CPA), Registered Nurse (RN), Bachelors of Science in Nursing (BSN).
Required Minimum Knowledge, Skills, Abilities and Training
  • Knowledge of federal and state laws and regulations regarding physician self-referral and fraud and abuse
  • Ability to work independently to manage multiple projects simultaneously
  • In depth knowledge of healthcare regulations and guidance relative to assigned subject matter area (acute, physician enterprise, post-acute, physician
    contracting, etc.)
  • Ability to research regulations and guidance for interpretive purposes
  • Ability to analyze data, identify and summarize trends.
  • Excellent written communication skills
  • Language, Math, Reasoning, Computer skills


While you're busy impacting the healthcare industry, we'll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility and more

#L-CSH

#Healthcare Compliance, CHC, RHIT, CCS, CPC, CPA, CCS-P, APC CHP, RHIA, RN

  • Environmental Compliance Specialist

    2 weeks ago

    Village of Williamsburg, United States Alpha Corporation Full time

    Job OverviewAlpha Corporation, a distinguished woman-owned enterprise established in 1979, excels in delivering comprehensive civil and structural engineering, program and construction management, project controls, and technology services across a variety of building types, transportation, and heavy infrastructure projects. Our clientele spans a wide array...

  • Credentialing Specialist

    1 week ago

    Greenwood Village, United States Rural Physicians Group Full time

    Job DescriptionJob DescriptionSalary: $20.19 - $30.88Rural Physicians Group is an expansive physician network of rural-focused hospitalist, surgicalist and APPs that are passionate about helping rural hospitals meet the needs of the communities we serve.  By working with Rural Physicians Group, our hospital partners receive full-time dedicated providers on...

  • People Operations Specialist

    2 weeks ago

    Greenwood Village, Colorado, United States Addison Group Full time

    Addison Group is seeking a qualified Human Resources Specialist to enhance our team. Position: Human Resources SpecialistWork Arrangement: On-site roleSalary Range: $65,000 - $70,000Working Hours: Monday to Friday, 8 AM to 5 PM Key Responsibilities:Guide management and staff on employment laws, organizational policies, and benefits, ensuring adherence to...

  • Financial Reporting Specialist

    3 days ago

    Greenwood Village, Colorado, United States CoralTree Hospitality Full time

    Job Summary:CoralTree Hospitality is seeking a highly skilled Financial Reporting Specialist to join our team. As a key member of our accounting department, you will be responsible for reconciling and analyzing balance sheet accounts to ensure accurate account balances and transaction details.Key Responsibilities:Reconcile general ledger and sub-ledger...

  • Operations Specialist

    3 weeks ago

    Greenwood Village, United States Sethmar Transportation Inc Full time

    As an Operations Specialist you will ensure operational excellence through supporting both internal and external customers and carriers. You will do this by tracking and tracing our shipments, making appointments, entering shipment data, communicating to help resolve issues and ensure on time departures/arrivals. You will provide excellent customer service...

  • Medical Claims Specialist

    2 weeks ago

    Greenwood Village, Colorado, United States Village Pediatrics PC Full time

    Job SummaryWe are seeking a detail-oriented Medical Claims Specialist to join our team at Village Pediatrics PC. The ideal candidate will be responsible for submitting medical claims to insurance companies and ensuring timely reimbursement.Key Responsibilities:Review and verify accuracy of billing data and revise any errorsPrepare and submit claims to...

  • Safety and Compliance Specialist

    6 days ago

    Elk Grove Village, Illinois, United States Yusen Logistics Full time

    About the RoleWe are seeking a highly skilled and experienced Safety and Compliance Specialist to join our team at Yusen Logistics (Americas) Inc. As a key member of our organization, you will play a critical role in ensuring the safety and well-being of our employees, customers, and the environment.Key ResponsibilitiesCompliance and Risk Management: Ensure...

  • Operations Specialist

    3 weeks ago

    Greenwood Village, United States Sethmar Full time

    Job DescriptionJob DescriptionDescription:As an Operations Specialist you will ensure operational excellence through supporting both internal and external customers and carriers. You will do this by tracking and tracing our shipments, making appointments, entering shipment data, communicating to help resolve issues and ensure on time departures/arrivals. You...

  • Operations Specialist

    1 month ago

    Greenwood Village, United States Sethmar Full time

    Job DescriptionJob DescriptionDescription:As an Operations Specialist you will ensure operational excellence through supporting both internal and external customers and carriers. You will do this by tracking and tracing our shipments, making appointments, entering shipment data, communicating to help resolve issues and ensure on time departures/arrivals. You...

  • Safety and Compliance Specialist

    2 days ago

    Greenwood, South Carolina, United States Walmart Full time

    Job SummaryWe are seeking a highly skilled Safety Coordinator to join our team at Walmart. As a Safety Coordinator, you will play a critical role in ensuring a safe working environment for our employees and customers.Key ResponsibilitiesDevelop and implement safety policies and procedures to minimize risks and prevent accidents.Conduct regular safety audits...

  • Grants Business Specialist

    3 weeks ago

    Greenwood Village, United States CommonSpirit Full time

    Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

  • Manufacturing Process Specialist

    2 weeks ago

    Greenwood Village, Colorado, United States Samuel Engineering Full time

    Join our team as a Manufacturing Process SpecialistCompany OverviewSamuel EngineeringAbout the RoleWe are seeking a Manufacturing Process Specialist to contribute expertise in the formulation and design of engineering methodologies for mineral and mining initiatives. Leverage advanced skills and specialized training to establish systems and unit operations...

  • Vendor Specialist

    3 months ago

    Greenwood Village, United States Xanterra Corporate Full time

    Overview Xanterra Travel Collection, is a growing, exceptional group of travel and leisure businesses operating across the globe. Our properties/services combine dramatic settings and landmark buildings with exceptional service to deliver unforgettable experiences. We are inspired by our guests, our environment, and each other. Headquartered in our...

  • Pavement Marking Specialist

    6 days ago

    Greenwood Village, Colorado, United States RoadSafe Traffic Full time

    About the JobWe are seeking a highly skilled Pavement Marking Technician III to join our team at RoadSafe Traffic Systems. As a key member of our team, you will be responsible for ensuring the safe and efficient installation of pavement markings and traffic control devices.Key ResponsibilitiesLead and Train Crew Members: Supervise and train crew members to...

  • Registered Nurse

    1 day ago

    Greenwood Village, Colorado, United States Enhabit Inc. Full time

    About Enhabit Inc.Enhabit Inc. is a leading provider of home-based care services, committed to delivering high-quality patient care in the comfort of their own homes.Job SummaryWe are seeking a highly skilled Registered Nurse to join our team as a Home Health Care Specialist. As a key member of our clinical team, you will be responsible for providing...

  • Procurement Specialist II

    3 weeks ago

    Greenwood Village, United States CommonSpirit Full time

    Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

  • EHS CHILD CARE PARTNERSHIP SPECIALIST

    2 weeks ago

    Greenwood Village, United States CIG Full time

    About Early Learning Ventures:Early Learning Ventures (ELV) is a nonprofit organization dedicated to expanding access to high-quality Early Care and Education (ECE). Through an innovative shared services model, ELV streamlines business functions for child care providers, making it easier to manage financially stable, high-quality businesses. By partnering...

  • EHS CHILD CARE PARTNERSHIP SPECIALIST

    2 weeks ago

    Greenwood Village, United States CIG Full time

    About Early Learning Ventures:Early Learning Ventures (ELV) is a nonprofit organization dedicated to expanding access to high-quality Early Care and Education (ECE). Through an innovative shared services model, ELV streamlines business functions for child care providers, making it easier to manage financially stable, high-quality businesses. By partnering...

  • Licensing Specialist

    2 weeks ago

    Greenwood Village, Colorado, United States Galloway & Company, Inc. Full time

    Position OverviewThe Licensing Specialist plays a crucial role in managing licensing responsibilities for Galloway & Company, Inc. This position entails overseeing the compliance of our corporate and professional licenses, ensuring they are up-to-date and in accordance with state regulations.Key Responsibilities1. Maintain an organized accounting system...

  • Senior Paralegal

    6 days ago

    Greenwood Village, Colorado, United States CoBank Full time

    About the RoleCoBank is seeking a highly skilled Senior Paralegal to join our team in a corporate law specialist role. As a key member of our legal department, you will be responsible for performing varied legal, title, abstract, and other necessary research to assist attorneys and supervisors with the performance of corporate and/or transactional legal...