Healthcare Compliance Specialist

3 weeks ago


New Providence, United States PRISM Vision Group Full time

Role and Responsibilities

Assist the Director of Compliance with-

Coordinating the compliance training program, including appropriate introductory training for new staff as well as annual compliance training for all PRISM staff.
The investigation of HIPAA incidents.
Maintaining the existing language assistance program and Implementing the PRISM language assistance program for integrations with new affiliates, including training.
Monthly OIG Exclusions/Sanctions Searches, including investigating potential matches and ruling them out.
Due Diligence and Integrations projects during PRISM joint ventures, acquisitions, and the like.
Coordination of the legal request for medical record requests process, including determining whether it is appropriate to approve the requested medical records.
Providing educational support to staff as needed.
Investigating Compliance Hotline concerns.
Assisting with maintenance of compliance applications and other databases as needed.
Other general duties as assigned.

Education, Training and Experience

3-5 years of healthcare compliance experience.
Bachelors degree or equivalent experience in a compliance role.
Compliance certification from HCCA, AAPC, or the like strongly preferred but not required.
Proficiency in or experience with healthcare compliance including The HIPAA Rule, HITECH, federal False Claims Act, Anti-kickback Statute, Fraud Waste and Abuse laws, and other healthcare compliance laws.

Knowledge and Skills & Expected Competencies

Detail-oriented and organized.
Effective oral and written communication skills.
Strong research skills.
Strong organizational skills.
Proficient in Microsoft Office Suite software including Word and Excel.
Basic understanding of CMS requirements.
Ability to stay current with the healthcare regulatory environment including regulatory changes.
Ability to deal effectively with individuals at all organizational levels, working independently and/or with teams.
Ability to manage multiple priorities and workflow at one time.

by Jobble



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