Compliance Specialist
3 weeks ago
Supports the Corporate Responsibility Program (CRP) by developing, implementing, and maintaining an effective and comprehensive compliance monitoring program.
Key Responsibilities- 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.
- 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.
- Bachelor's degree – equivalent education/experience may be considered in lieu of degree.
- Minimum 3 years of experience in contracts auditing and monitoring.
- 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 Professional Coder through AAPC (CPC), Certified Public Accountant (CPA), Registered Nurse (RN), Bachelors of Science in Nursing (BSN).
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