Field Compliance Specialist - RN

Heart to Heart Hospice•Plano, TX

About The Position

At Heart to Heart Hospice, we provide “Compassionate Care from Our Hearts to Yours.” Our employees enhance the lives of patients with life-limiting illnesses and their loved ones,during a time when compassionate care is needed most. We are dedicated to making a difference in the lives of employees, offering the opportunity to be associated with caring teammates, and creating positive contributions in each community we serve. Field Compliance Specialist What You Will Do Audits hospice medical records and internal admin processes to monitor regulatory compliance and to ensure adherence to established processes and workflows. Identifies areas of potential risk through audit processes. Present and discuss audit findings through formal exit process. Review, approve and monitor Plan of correction. Assists the organization's compliance leadership, as directed, to research and investigate complaints, concerns or questions relative to compliance issues. Investigates and follows up on reported issues as directed. Maintains awareness of laws and regulations and conducts research as needed to identify applicable laws, regulations and practices to maintain compliance Communicates applicable eligibility and/or quality of care compliance issues to the Site, Area and Regional teams and Chief Clinical Director and Compliance Department Responds to denials and requests for additional data requests (ADRs) in an accurate and timely manner Timely submission of all documentation Performance of other duties as required Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures It is this Agency's policy to provide equal employment opportunities without regard to age, race, color, religion, military status, gender preference, sex, marital status, national origin or disability.

Requirements

Registered Nurse required (active state license)
Minimum of two (2) years of experience in clinical setting, preferably with Hospice, Quality/QAPI experience, and two (2) years medical-surgical experience
Ability to train and teach staff members in the use of Home Care Home Base (HCHB), Allscripts, databases, Imaging software, E-Solutions, Maven, Nuance and etc.
Good working knowledge of Local Coverage Determinants for Hospice (multiple states), Medicare Conditions of Participation (CoPs), and knowledge of the Community Health Accreditation Partners (CHAP)
Ability to travel

Nice To Haves

Certified in Hospice and Palliative Care preferred

Responsibilities

Audits hospice medical records and internal admin processes to monitor regulatory compliance and to ensure adherence to established processes and workflows.
Identifies areas of potential risk through audit processes.
Present and discuss audit findings through formal exit process.
Review, approve and monitor Plan of correction.
Assists the organization's compliance leadership, as directed, to research and investigate complaints, concerns or questions relative to compliance issues.
Investigates and follows up on reported issues as directed.
Maintains awareness of laws and regulations and conducts research as needed to identify applicable laws, regulations and practices to maintain compliance
Communicates applicable eligibility and/or quality of care compliance issues to the Site, Area and Regional teams and Chief Clinical Director and Compliance Department
Responds to denials and requests for additional data requests (ADRs) in an accurate and timely manner
Timely submission of all documentation
Performance of other duties as required
Ensure overall compliance with local, state and federal laws, Medicare regulations, and established personnel policies and procedures