Advocacy / Non-Profit, Hospital, Public and Private
4 Year Degree
Reports To: Corporate Director of Compliance, Quality and Risk Management
Purpose: To assist in the management and promotion of the corporate compliance program. Assist as a subject matter expert on all compliance related issues, maintains advanced level of knowledge of current compliance laws, regulations, and best practices and has the ability to conduct effective compliance related audits and education.
Degree of Supervision: Must be able to work independently. Meetings with supervisor bi-weekly
Main Duties and Responsibilities:
Collaborate with the Corporate Director of Compliance in designing and executing internal, external, and provider audits.
Conduct compliance investigations and assist Privacy officer in conducting privacy investigations.
Conduct audits in areas of accounting, finance, billing practices, human resources, information technology and other departments as directed by the Corporate Director of Compliance, Quality & Risk.
Develop and track compliance corrective action plans that result from audits.
Provide education to staff on compliance related laws, regulations and standards. In addition, provide departmental education to staff following each audit conducted.
Develop and conduct compliance trainings, when directed by the Corporate Director of Compliance, Quality & Risk.
Make recommended changes to procedures and practices that are not in compliance with laws and regulations.
Track and communicate changes to law, regulation, accreditation standards, and best practice guidelines related to accounting, finance, coding, billing practices, human resources and other administrative departments. Additionally, communicate and monitor changes in Health Plan contracts and Medicare/Medicaid billing regulations, laws and guidelines.
Manage compliance projects.
Other duties as assigned.
Must be able to work extended hours and deliver presentations which may be lengthy or multiple in one day.
Must be able to sit and perform computer work for majority of work day.
Must be able to move throughout all Caron facilities as well as travel to meet business needs.
Light lifting up to 20 pounds (manuals, notebook computers, LCD, etc.)
Requires close visual acuity, analyzing data and figures and viewing a computer terminal.
Must possess an Bachelor’s degree in law, health administration, business administration, finance/accounting or related field.
Working knowledge of health care compliance related regulations, laws and practices such as accounting, finance, coding, billing, Health Plan contracts, Medicare/Medicaid billing regulations, substance use disorder treatment documentation requirements, the HIPAA Privacy Rule, human resources and environment of care.
Two years of experience in compliance in a health care setting.
Experience in audit and assessment techniques preferred.
Strong verbal and written communication and presentation skills.
Proficient computer skills in MS Word, Excel, Outlook, PowerPoint.
If in recovery, 1-year continuous sobriety preferred.
Knowledge, Skills, and Abilities:
Thorough understanding of MS Office software (Excel, Word, Powerpoint & Outlook)
Organizational skills and multitasking ability
Detail oriented with excellent follow-through.
Ability to take initiative and work with minimal supervision
Ability to communicate and cooperate with employees of all levels.
Competence and Measurements:
Can communicate with peers and coworkers in a professional and cooperative manner.
Internal Number: 18-0149
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