Director of Healthcare Compliance - Integrity & Compliance

Education & Experience

Bachelor's degree in business, healthcare or related field plus five years' related compliance experience in a healthcare setting. Two years of supervisory experience preferred. Certification in healthcare compliance, registered Health Information Administrator preferred.

CERTIFICATIONS, LICENSES OR REGISTRATION REQUIRED:  NA

Knowledge, Skills & Abilities

Advanced knowledge of medical billing, to include billing policies and procedures for federal payers; advanced knowledge of medical coding and coding guidelines, for both professional billing and facility/institutional billing; knowledge of federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare; knowledge of accounting/business principles; verbal and written communication skills; possess the ability to speak in public settings/forums; analytical/critical thinking skills; ability to work independently and in a group setting; have knowledge about and be skilled in utilizing basic business software applications.

RESPONSIBILITIES

• Provide day-to-day management of assigned staff and providing direction to staff regarding audits, healthcare rules, laws and regulations .
• Coordinate and facilitate committee meeting, to include those compliance subcommittees that oversee compliance of the university health system.
• Stay abreast of federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare, third-party billing policies/procedures to include specifically federal payers, and coding updates.
• Develops, implements, and maintains system-wide programs, policies and procedures to ensure compliance with federal and state rules, laws, regulations, policies/procedures, etc. that are applicable to healthcare.
• Develops and implements/presents training, as needed, to ensure institutional healthcare compliance.  This will include both group and individual training, as necessary.
• Investigates/reviews allegations of alleged compliance plan violations, as needed or directed.
• The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Physical and Environmental Demands
Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, frequent work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, occasional reaching, frequent sitting, frequent standing, frequent twisting, and frequent walking. (occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)