|Skills:||Healthcare compliance,internal audit,coding,billing,finance
|Required Certifications:||CPC,CPA,RN,CHRC,CCS-P,RHIA,RHIT,CHP,CHC,CCS,CHPC,or BSN
|Preferred Certifications:||CCS-P,CPC,CHC,CHRC,CHPC,RHIT,CCS,CHP,RN,CPA,RHIA,or BSN
|Required Experience:||3 to 4 years
The Compliance Specialist will support the CRP by developing, implementing, and maintaining an effective and comprehensive compliance monitoring program. The Compliance Specialist will provide monitoring and auditing activities across CommonSpirit Health by conducting and/or facilitating reviews, analyzing outcomes, communicating findings, and ensuring follow-up on action plans as appropriate.
Supports the CRP Compliance Monitoring Manager in 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.
Recommends changes to improve processes, strengthen controls, and promote compliance.
Provides education to departments regarding audit findings, reimbursement impact, identified compliance issues and risk mitigation.
Maintains monitoring statistics for tracking and trending purposes.
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.
Assists with tracking follow up with operations on development, implementation and completion of action plans.
Maintains a high level of competency related to compliance by attending appropriate education as provided by CommonSpirit Health. Monitors federal and state rules and regulations for compliance related changes that may impact the organization.
Assists with daily department operations and completes special projects as assigned.
Bachelor’s Degree in hospital administration, finance, law, accounting, health information management, nursing, business or related health care field required. Experience in lieu of a bachelor’s degree may be considered.
One of the following certifications is required: CHC, CHRC, CHPC, RHIT, RHIA, CHP, CCS-P, CCS, CPC, CPA, RN, or BSN.
Minimum of three to five years of experience in health care compliance, internal audit, coding, billing, finance or other related field.