Compliance Specialist

Tennessee Oncology•Nashville, TN

7d•Onsite

About The Position

The compliance specialist provides compliance and privacy support to the organization. Their duties may include conducting audits, monitoring action plans, investigating matters as assigned, providing education and training, and participating in projects to help ensure that Tennessee Oncology is compliant with local, state, and federal laws, rules, and regulations.

Requirements

Ability to work independently
Excellent investigative skills
Ability to communicate effectively
High level of integrity and confidentiality
Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
Knowledge of and ability to utilize conflict resolution and problem-solving techniques.
Proficient in the use of Microsoft Word, Excel, Visio, and PowerPoint.
Ability to prioritize tasks and meet deadlines.
Must maintain a valid driver’s license.
A minimum of an associate degree, bachelor preferred, in a healthcare related field
At least 5+ years healthcare compliance and / or privacy experience.
Healthcare organization knowledge of operations, quality assurance, HIPAA, revenue cycle management, coding and billing, safety, federal and state healthcare regulations.
Knowledge of current laws, regulations, administrative guidance and industry practices that affect compliance obligations including Stark, Anti-kickback, HIPAA, Medicaid/Medicare regulations, and CMS Fraud, Waste, and Abuse guidelines.

Nice To Haves

Compliance and / or privacy certification(s) desired but not required.

Responsibilities

Assist Chief Compliance & Privacy Officer with day-to-day operations of the department.
Assist with preparing audit work papers and reports to effectively conduct, document, and communicate all compliance audit activities.
Conduct audits including coding, billing, provider documentation, and reimbursement processes and others as assigned.
Compose reports which accurately outline any findings as a result of the audit work.
Assist with conducting annual compliance risk assessments, work plans and action plans that mitigate findings.
Assist in investigations of compliance and privacy concerns.
Assist with complete, accurate and timely closure documentation of complaints from patients, staff, and internal or external providers, including hotline complaints.
Create and maintain compliance and privacy event logs.
Establish a structured process for tracking new and upcoming regulatory changes and collaborate with other departments to develop and initiate plans to educate Tennessee Oncology employees on relevant regulatory program requirements.
Assist in the development and provision of compliance and privacy training for providers, employees, and other workforce members.
Track completion rates of all employees, both for New Hire and Annual Training Assignments.
Assist with creating and reviewing compliance policies and procedures.
Participate in periodic reviews and revisions of the Notice of Privacy Practices, Code of Conduct and other regulatory documents as needed.
Review and resolve the OIG Exclusion List on a monthly basis.
Conduct compliance and privacy walk-throughs in all Tennessee Oncology locations.
Maintain a strong working knowledge of local, state, and federal rules and regulations.
Research and answer questions from staff regarding compliance and privacy regulations.
Perform USER activity audits as assigned.
Perform duties in accordance with Tennessee Oncology mission, values and policies and procedures.
Perform other duties as assigned.