Compliance Specialist/Auditor - (CHC or AHIMA or AAPC certification required)

MISSION

Through a collaborative and positive approach, the Compliance Specialist/Auditor will promote ongoing organizational compliance, revenue integrity, and efforts to provide efficient and effective services to patients. Using the results of audit/monitoring activities, this role will improve identification of opportunities to mitigate risks of potential non-compliance with regulations, policy, and industry standards, while facilitating process improvement.

OUTCOMES

1. Perform regular and ad hoc reviews of key organizational risks (e.g. policies, processes, clinical documentation, statutory and regulatory changes) to promote ongoing organizational accuracy, compliance, and risk mitigation.
2. Provide individualized and actionable feedback based on audit results.
3. Develop appropriate educational and resource materials.
4. Assist with audit & compliance related special projects as requested.
5. Use strong written, verbal, and “people” skills to convey complex information to providers, managers, and leaders.

COMPETENCIES

Job Related Competencies:

1. Manages Ambiguity: Operating efficiently, even when things are not certain, or the way forward is not clear.
2. Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
3. Courage: Stepping up to address difficult issues, saying what needs to be said.
4. Decision Quality: Making good and timely decisions that keep the organizations moving forward
5. Situational Adaptability: Adapting demeanor and approach in real time to match the shifting demands of different situations.

   Cultural Competencies:

   Advanced Values:

   1. People
   • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives
6. Heart

• Patient Focus: Building strong patient relationships and delivering patient centric solutions

• Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity

• Cultivates Innovation: Creating new and better ways for the organization to be successful

Behaviors:

1. Being Resilient:

• Rebounding from setback and adversity when facing difficult situations

• Actively seeking new ways to grow and be challenged using both formal and informal development challenges

• Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement

• Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone

QUALIFICATIONS

Basic Qualifications:

Education:

• Associate’s or Bachelor’s Degree in public health, healthcare management, health informatics

Previous, Job Relevant Work Experience:

• 5 years of experience in coding, clinical documentation
• Knowledge of electronic health record systems
• Knowledge of auditing methodology
• A combination of training, education, and experience that is equivalent to the employment standard listed above
• MUST have strong written and verbal communication skills across various levels of the organization.

Credentials/Licensures:

• MUST HAVE: Certification in Healthcare Compliance (CHC); OR Certification in physician coding from AHIMA or AAPC

Preferred Qualifications:

Education:

• Bachelor’s Degree in public health, healthcare management, health informatics

Previous, Job Relevant Work Experience:

• Previous experience in Urology/Gynecology field
• Previous experience in physician office and ASC settings