JOB SUMMARY: Responsible for assisting the Compliance Team with coordination of compliance efforts across the state and ensuring the practice remains in compliance with all regulations and requirements. This full-time position will assist the Compliance Team with documentation, compliance training, audits, and investigations related to the administration of OrthoVirginia's Compliance Program. This includes assisting employees, overseeing compliance systems and verifying policies. Proactive monitoring of compliance will be essential to the position.Job Responsibilities and Accountabilities:
- Assists with monitoring and assessing OrthoVirginia's Compliance Program
- Monitors compliance reporting including overseeing and managing ComplyTrack (ensure incidents are reported correctly and closed in a timely fashion); Trains providers and staff on using ComplyTrack
- Assists in the development of compliance education and training; Coordinates compliance education and training; Ensures annual training and new hire training is completed and documented appropriately
- Documents all compliance-related findings in ComplyTrack
- Compiles and summarizes compliance data, including breach statistics and survey data
- Facilitates and documents requests and referrals for coding and ad-hoc trainings received from practice staff; catalogs coding audits, tracks failed audits and required remedial training, and monitors rate of provider over-coding and under-coding
- Assists HIPAA Privacy Officer with HIPAA incident investigations, risk assessments, and breach notifications
- Facilitates annual physician conflict of interest/open payments evaluation process
- Facilitates annual employee conflict of interest/relationships evaluation process
- Assists with compliance audits, monitoring and investigations; Participates in external investigations by regulatory agencies
- Drafts one pagers and tip sheets on compliance issues
- Takes appropriate actions as approved by the Compliance Director
Qualified Candidates must meet all of the following criteria:
- Bachelor's Degree or equivalent with 3 to 5 years of relevant compliance/auditing experience in medical or insurance setting
- Compliance Certification (e.g. CHC, CHPC, CHPS) or Certified Professional Coder (CPC) desirable
- Strong analytical and problem-solving skills required including experience auditing and manipulating large quantities of data
- Ability to exercise initiative, problem-solving and decision-making to effectively plan, prioritize, and complete projects/tasks with minimal supervision in a fast paced, changing environment
- General knowledge of regulatory requirements relating to documentation, claims processing, reimbursement, coding, HIPAA, OSHA standards applicable to the healthcare industry and other compliance related regulations
- Advanced working experience in Microsoft Office including Excel (formulas, pivot tables, dashboards, etc.)
- Exceptional written and strong verbal communication skills: face to face, email, written correspondence, telephone
Other:
- Has access to and knowledge of extremely sensitive, private and confidential materials-ability to maintain the highest standard is required with zero tolerance
- Participates in professional development efforts to ensure currency in health care policies and trends
- Maintains detailed knowledge of compliance management and other computer software as it relates to job functions
- Attends required meetings and participates in committees as requested
- Performs all other tasks and projects assigned by the Compliance Director
Typical Physical Demands:Position requires full range of body motion including handling and lifting, manual and finger dexterity and eye-hand coordination. Involves standing and walking. Employee will occasionally be asked to lift and carry items weighing up to 30 pounds. Normal visual acuity and hearing are required. Employee will work under stressful conditions, and work irregular hours. Employee may have frequent exposure to communicable diseases, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment.Pre-Employment background check, drug screen and TB test required for all new hires. OrthoVirginia, Inc. is an Equal Opportunity Employer. #STATEOV