Compliance Specialist

3 weeks ago


Englewood, Colorado, United States Unavailable Full time
Job Summary

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.
Requirements
  • 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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