Regulatory Compliance Specialist I

Kettering Health • Miamisburg, OH

3d • Hybrid

About The Position

The Regulatory Compliance Specialist I supports quality patient care and adherence to federal regulations prohibiting fraud, waste, and abuse of federal healthcare programs. The role completes billing and coding audits, provides education, and supports the return of overpayments to payers. It stays apprised of new billing and coding rules and regulatory changes, monitors OIG and CGS work plans, and assists with dangerous drug audits. Other duties may be assigned. All responsibilities are carried out in alignment with Kettering Health's mission, vision, values, and B Safe program.

Requirements

• Bachelor's degree in healthcare administration, business administration, law, life sciences, or a related field, or an equivalent combination of education and relevant experience.
• Typically 0–2 years of experience in healthcare compliance, regulatory affairs, privacy, or a related field; experience may include internships or practicum in compliance or regulatory settings.
• Knowledge of federal and state healthcare regulations, including HIPAA, OSHA, and other regulatory agencies.
• Ability to interpret and apply regulatory standards.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent written and verbal communication skills.
• Proficiency with Microsoft Office Suite and ability to learn compliance management software.
• Attention to detail and organizational skills.
• Ability to work independently and collaboratively.

Nice To Haves

• Experience developing or implementing compliance policies, procedures, or training in a healthcare environment.
• Certified Coder credential (CPC or CCS/CCS-P), or ability to complete and pass a coding certification within 12 months of hire.

Responsibilities

• Complete billing and coding audits.
• Provide education related to compliance.
• Support the return of overpayments to payers.
• Stay apprised of new billing and coding rules and regulatory changes.
• Monitor OIG and CGS work plans.
• Assist with dangerous drug audits.
• Perform other duties as assigned.
• Carry out responsibilities in alignment with Kettering Health's mission, vision, values, and B Safe program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level