• Compliance Specialist Healthcare (Madison)

    Job Locations 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 a love of compliance and learning.  Must have 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 and north central Illinois.

    Responsibilities

    In this support role, the Compliance Specialist will assist the Director of Compliance in ensuring Agrace's continued compliance with federal, state, local and accrediting agency requirements. Responsibilities include:

     

    Research regulations and analyze compliance information

    • Read, analyze and interpret relevant hospice and health care compliance information from accreditation program(s) and from National Hospice and Palliative Care Organizations and regulating agencies such as Department of Health and Human Services, Center for Medicare and Medicaid Services, Office of Civil Rights, Office of the Inspector General, Wisconsin Department of Health Services, etc.
    • Analyze compliance information and use it to identify areas of risk within Agrace and to determine level and immediacy of concern.

    Monitor compliance and assist in resolution of compliance related concerns

    • Assist with the development and implementation of audit/monitoring programs to measure performance against compliance obligations.
    • Collaborate with clinical leaders and other staff to identify and resolve compliance-related issues. Assist in the development and implementation of processes to address compliance concerns.

    Communicate compliance related information

    • Assist in the review and revision of policies & procedures, forms, manuals, and reference materials to ensure compliance with applicable regulations and agency standards.
    • Draft compliance related correspondence to patients and families.
    • Educate staff on compliance issues. Assist in the development and presentation of compliance related training materials.
    • Coordinate Agrace’s response to findings from internal and external monitoring and audit activities, such as requests from the Center for Medicare and Medicaid Services and its contractors

    Qualifications

    Requirements

    • Associates Degree in healthcare administration, communication, required, Bachelor’s degree, preferred.
    • Certification/Registration/Licensure: paralegal and/or health care compliance certification, preferred.

    Skills and Abilities

    • 1-2 years’ experience with health care compliance, auditing, billing, coding, reimbursement and/or information management
    • Knowledge of healthcare regulations and operations
    • Effective written and verbal communication skills
    • Knowledge of medical terminology, coding and payment methodologies, billing, information systems, health documentation and quality monitoring processes
    • Ability to be flexible time and task to meet organizational needs
    • Intermediate Microsoft office skills

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