Category:

Professional

City:

Jackson

State:

Tennessee

Shift:

8 - Day (United States of America)

Job Description Summary:

The primary responsibility of the Compliance Coordinator is to provide support for all operations and initiatives critical to enterprise-wide Compliance Program needs. Through effective partnerships with business unit stakeholders, this individual supports compliance functions, which include, but are not limited to, preparation for, and coordination of regulatory and other external audits, investigations and response to allegations of non-compliance, deliver of compliant training, policy and procedure review, and auditing and monitoring activities. In addition, this individual may also provide assistance with privacy-related investigations, accreditation requirements, and monitoring revenue cycle activities.

1.    Oversees and manages compliance projects of moderate complexity to the desired outcomes.
2.    Assists the Chief Compliance Officer with periodic reviews and revisions to the Compliance program in light of changes in the law and the requirements of federal and stated funded health care programs and in the needs of the organization; 
3.    Develops, coordinates and participates in a multifaceted education and training program that focuses on the elements of the Compliance program, and seeks to ensure that management and all appropriate employees are knowledgeable of, and comply with, ethical standards and federal and state laws, rules, and regulations; 
4.    Investigates complaints received by anonymous compliance hotline or any other means, and reports findings to leadership as appropriate. 
5.    Tracks correspondence from governmental agencies and payers to ensure Compliance Office is aware of denial trends, appeals, payer activities, and alerts departments to issues, if necessary. 
6.    Assists managers in coordinating internal compliance review and monitoring activities, including annual or periodic reviews of departments; 
7.    Independently investigates and acts on matters related to compliance, including the flexibility to design and coordinate internal investigations and any resulting corrective action within the organization, providers and sub-providers, agents and, if appropriate, independent contractors; 
8.    Develops and maintains needed policies and procedures in accordance with all standards, laws, rules, and regulations, making updates as needed; 
9.    Develops policies and programs that encourage managers, employees, physicians and patients to report suspected fraud and other improprieties without fear of retaliation; 
10.    Assists with accreditation activities, as needed. 
11.    Participates in and analyzes the information obtained from all audits conducted in the organization; evaluating for potential violations of the laws, rules, and regulations; 
12.    Develops and administers policies and procedures for the Compliance Office, making updates as required by program changes or development; 
13.    Performs other duties as assigned or requested.

JOB SPECIFICATIONS:

EDUCATION:

• Minimum of Bachelor’s Degree in a healthcare-related field required, or equivalent combination of education, training, and work experience required.

LICENSURE, REGISTRATION, CERTIFICATION:

• Current licensure or certification in a healthcare related field or certification in healthcare compliance preferred.

EXPERIENCE:

• Minimum of 3 years of experience in a health care discipline, preferably in a Clinical, Compliance, Risk Management, Billing or Legal Function.

KNOWLEDGE, SKILLS AND ABILITIES:

• Excellent verbal communication skills, good business and finance backgrounds are essential.
• This person should be proficient in establishing relationships and possess exemplary personal management skills.
• A fundamental knowledge of all applicable state and federal laws, rules and regulations is preferred.
• Knowledge and understanding of computer programs, such as word processing, multimedia presentations, and spreadsheets.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.