Compliance Specialist
Supports the development and maintenance of a compliance culture within Boone health by managing and interpreting data related to requests for reviews or audits of compliance-related issues and matters. Reviews may be driven by internal or external requests, including those from Government agencies or related contractors and payors, patients, employees, and physicians. Involved in developing reports based on the data analyzed and communicating the results, verbally and in writing, to appropriate stakeholders.
Supports management in the analysis and interpretation of data to identify trends or areas requiring attention.
Performs data entry for projects, processes and investigations managed by the department.
Coordinates and communicates with appropriate stakeholders to ensure timely awareness of sensitive issues and completion of affected tasks and requests.
Participate in resolving potential and / or actual regulatory compliance issues collaboratively with leadership and other departments, as appropriate.
Manages the process for tracking and ensuring compliance with related deadlines. Coordinates the submission of required reporting.
Prepares summaries resulting from researching related billing or coding compliance issues or related regulatory changes or events.
Review exclusion screening and conflict of interest reports to determine if issues are present and, if so, determine the best course of action for response.
Facilitate internal and external audits as part of the compliance work plan, as well as in response to reported and detected compliance issues. This will include reviewing records, reports, software and any other relevant programs. After completing the audit, make recommended changes to procedures and practices that are not in compliance with regulations and help implement a plan to address such changes.
Performs Other Responsibilities as Assigned.
Degree : High School Diploma or GED, Associate's Degree
Experience : 5-10 Years
Supervisor Experience : None Required
Licenses & Certification : None Required
Degree : Bachelor's Degree in Business / Healthcare Administration / Related Field
Experience : 10+ Years
Supervisor Experience :
Licenses & Certification : RHIA
Day Shift (United States of America)
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
Senior Compliance Analyst • Columbia, MO, US