Compliance Specialist | Compliance | Days | Full Time
About The Position
The role is responsible for providing ongoing compliance monitoring and auditing for a multi-hospital healthcare system. Key functions include the review and analysis of: Regulatory requirements, including but not limited to documentation and medical necessity Compliance with applicable laws, rules, guidelines and regulations Auditing, monitoring and special projects General compliance training and education Enterprise compliance policies and written standards of conduct General compliance processes, including inquiries, investigations and responding to reported, suspected, or confirmed non-compliance These activities ensure both appropriate reimbursement for the hospital and adherence to all applicable laws, rules, guidelines, and regulations.
Requirements
- Bachelor's degree and two (2) years of experience in compliance, clinical, coding, auditing, legal, or related fields; OR
- Associate's degree in a health or business-related field and four (4) years of experience in compliance, clinical, coding, auditing, legal, or related fields; OR
- Relevant certifications in Compliance, Coding, and/or Auditing and six (6) years of experience in compliance, clinical, coding, auditing, legal, or related fields, with knowledge of healthcare laws and regulations governing hospitals and/or the healthcare industry.
- Must be knowledgeable of Medicare, Medicaid, and state and federal laws and regulations governing the healthcare industry.
- Ability to research and interpret complex regulations is required.
- Proven problem-solving skills are essential.
- Proficient with Microsoft Office tools, including Excel, Word, and PowerPoint.
- Must be organized, versatile, and able to work independently.
Nice To Haves
- Certified in Healthcare Compliance (CHC) credential preferred.
- Registered Nurse (RN), Licensed Practical Nurse (LPN), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder - Hospital/Outpatient (CPC-H/COC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) preferred.
- Familiarity with hospital billing systems and medical records.
- Strong coding skills and a clinical background preferred.
Responsibilities
- Conduct ongoing compliance monitoring and auditing across UF Health.
- Perform analyses to support regulatory compliance.
- Fosters open lines of communication and communicates key compliance topics to staff and UF Health leadership.
- Deliver compliance education and training to staff.
- Research and respond to compliance-related inquiries.
- Follow established investigation protocols to address reported, suspected, or confirmed non-compliance.
- Participate in and contribute to compliance meetings, encouraging open communication throughout the organization.
- Assist in developing and monitoring special compliance projects in collaboration with Compliance Managers and various hospital departments.
- Provide compliance advice and guidance to staff and leadership, as needed.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Number of Employees
5,001-10,000 employees
