Compliance Specialist Healthcare (Madison)

US-WI-Madison
Category
Quality/Compliance
Type
Regular Full-Time 1.0 FTE
Full Time Equivalent
1.0 FTE (40 hours/week)
On Call Responsibilities
none
Weekend Rotation
none

Overview

Join Agrace as a Compliance Specialist and make a meaningful difference in a patient's experience.  This is an ideal opportunity for an organized person with great writing and research skills and previous healthcare-related compliance experience.  

For more than 35 years, Agrace has been a nonprofit, community based health care agency dedicated to providing expert physical, emotional and spiritual support to patients and families through the stages of serious illness. Agrace HospiceCare is nationally recognized for the comprehensive hospice services we provide in patients' homes, the Agrace HospiceCare inpatient unit and skilled nursing and assisted living facilities throughout south central Wisconsin.Make a difference for patients and families.

Responsibilities

The Compliance Specialist will assist the Chief Compliance Officer in developing, maintaining and administering the Agrace Compliance Program, to ensure continued compliance with federal, state, local and accrediting agency requirements. Duties include:

  • Monitor and disseminate information from compliance resources, including the Department of Health and Human Services, the Center for Medicare and Medicaid Services, the Office of Civil Rights, the Office of the Inspector General, the Wisconsin Department of Health Services, the Applicable accreditation program(s); National Hospice and Palliative Care Organization, as well as other resources with relevant hospice and health care compliance-related information.
  • Participate in the identification of risk areas, analyze areas of immediate concern.
  • Work collaboratively with clinical leaders and other staff to identify and resolve compliance-related issues, including the development and implementation of processes to address compliance concerns.
  • Support the review and revision of policies & procedures, forms, manuals, and reference materials to ensure compliance with applicable regulations and agency standards.
  • Educate staff on compliance policies and regulations and assist in the development of compliance education and training materials.
  • Assist with the development and implementation of audit/monitoring programs to measure performance against compliance obligations.
  • Coordinate responses to findings from internal and external monitoring and audit activities, including requests from the Center for Medicare and Medicaid Services and its contractors.
  • Assist in drafting correspondence to patients and families, when compliance issues are involved.

Qualifications

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Education Requirements:

  • Associates Degree, required, Bachelor’s degree, preferred.
  • Certification/Registration/Licensure: paralegal and/or health care compliance certification, preferred.Knowledge, Skills and Abilities

Knowledge/Skills Requirements:

  • Minimum of 2-3 years experience with health care compliance, auditing, billing, coding, reimbursement and/or information management, required.
  • Minimum 3 years experience in business or clinical operations in a clinical setting, required.
  • In-depth working knowledge of regulatory and operational aspects of health care, required.
  • Knowledge of medical terminology, coding and payment methodologies, billing, information systems, health documentation and quality monitoring processes, required.
  • Microsoft Office competency, required.
  • Must be detail-oriented with strong analytical, research, and organizational skills.
  • Must have excellent verbal and written communication skills.

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