Corporate Compliance Manager/Corp Compliance/FT/Days

Mô tả công việc

SUMMARY: The Manager of Corporate Compliance will assist in the development, coordination, implementation and the on-going review and monitoring of the Compliance Program. The Compliance Manager will be responsible for reporting irregularities and findings to the AVP of Corp Compliance. The Compliance Program and its operations must meet or exceed the expectations of the Office of the Inspector General of the Department of Health and Human Services and other federal and state regulatory enforcement agencies.  The Compliance Manager, with oversight from the AVP of Corp Compliance will be responsible for ensuring that the operations of the hospital comply with all laws and regulations. The Compliance Manager will be responsible for keeping abreast of changes in laws and regulations that impact the hospital’s operations to ensure compliance, and will be responsible for assisting in implementing the changes. ESSENTIAL DUTIES AND RESPONSIBILITIES: The Compliance Manager will serve as an informational resource by responding to questions or inquiries relating to Compliance, HIPAA, and other federal, state, and regulatory matters. The Compliance Manager will be responsible for conducting complaint driven compliance concern/investigations from the Compliance Hotline or any other means. Conduct special compliance investigations as designated by the AVP of Corp Compliance; conduct HIPAA breach investigation in coordination with HR and work with HR and the Privacy Officer on HIPAA issues. Will document and report to the AVP of Corp Compliance any findings, and will be responsible for proposing any corrective action and ensure that corrective actions are followed through. Conduct compliance education/in-services; perform chart and bill audits for medical necessity and billing criteria compliance. Conduct audits as outlined by the annual audit plan and provide reports outlining the findings and the corrective action needed. Develope and present educational materials, based on audit findings to management and billing staff regarding correct coding guidelines and governmental regulations. Assist with the development and implementation of Corporate Compliance Policies and Procedures. Responsible for establishing and serving on hospital Compliance Committee. Knowledge of Stark Law and False Claims Act. Knowledge of EMTALA Law.  *CB*