Compliance Specialist
The posted compensation range of $33.68 - $48.84 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Responsibilities
JOB SUMMARY / PURPOSE
Supports the Corporate Responsibility Program (CRP) by developing, implementing, and maintaining an effective and comprehensive compliance monitoring program. 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.
ESSENTIAL KEY JOB RESPONSIBILITIES
- 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.
- Conducts reviews to include physician payments, business associate agreements, lease agreements, etc.
- Participates in the Physician Transaction contracting process as assigned
- Participates in divestiture and acquisition projects as applicable
Qualifications
Required Education and Experience
- Bachelor’s degree – equivalent education/experience may be considered in lieu of degree.
- Minimum 3 years of experience in contracts auditing and monitoring.
Required Licensure and Certifications
- One of the following is preferred upon hire or required within first year of employment: 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 Prof. Coder through AAPC (CPC), Certified Public Accountant (CPA), Registered Nurse (RN), Bachelors of Science in Nursing (BSN).
Required Minimum Knowledge, Skills, Abilities and Training
- Knowledge of federal and state laws and regulations regarding physician self-referral and fraud and abuse
- Ability to work independently to manage multiple projects simultaneously
- In depth knowledge of healthcare regulations and guidance relative to assigned subject matter area (acute, physician enterprise, post-acute, physician
contracting, etc.) - Ability to research regulations and guidance for interpretive purposes
- Ability to analyze data, identify and summarize trends.
- Excellent written communication skills
- Language, Math, Reasoning, Computer skills
While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility and more!
#L-CSH
#Healthcare Compliance, CHC, RHIT, CCS, CPC, CPA, CCS-P, APC CHP, RHIA, RN
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
Apply
Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
No featured jobs
No recently viewed jobs
You have no saved jobs
Equal Opportunity
CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.