Compliance Specialist

Oakwood, Georgia, Job Category: Legal / Compliance Work Shift/Schedule: 8 Hr Morning – Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role: Job Summary The primary function of this position is to assist management in the development of and to improve the effectiveness of NGHS’s compliance program, which helps to ensure compliance with the federal and state laws, regulations, and rules governing tax-exempt healthcare entities, including rules and regulations concerning coding, billing, clinical documentation, physician and vendor relationships and other regulations that govern NGHS’ healthcare operations. Minimum Job Qualifications Licensure or other certifications: Educational Requirements: Bachelors Degree. A minimum five (5) years of work experience in compliance, coding, billing, medical record documentation, revenue cycle or health care operations may be considered in lieu of formal degree. Minimum Experience: Minimum of two (2) years’ experience performing work related to identifying, analyzing, evaluating compliance or legal issues and making recommendations. Other: Preferred Job Qualifications Preferred Licensure or other certifications: Certification in Healthcare Compliance ( CHC from HCCA). Preferred Educational Requirements: Preferred Experience: Healthcare experience is a plus but not required. Other: Job Specific and Unique Knowledge, Skills and Abilities Strong analytical and problem solving skills Be able to perform research and analysis, and summarize information Knowledge in the state and federal laws, statutes, regulations and guidelines Possess the ability to plan and execute work projects in a detailed and organized manner. Essential Tasks and Responsibilities Participate in the design and implementation of a risk based annual compliance work plan incorporating federal and state laws, rules, and regulations; industry alerts; and compliance program requirements and best practices. Develop compliance-related policies and procedures.

Participate in internal compliance investigations and maintain thorough documentation of all compliance reports, investigations and inquiries. Participate in the preparation and delivery of the annual and ongoing compliance training and education programs. Design and perform compliance audits including but not limited billing and coding audits and physician relationship audits. Assists with the development of and monitoring the sufficiency corrective action plans. Serve as a resource for compliance related inquiries, researching relevant regulations and communicating the need for additional policies and procedures, education, or other corrective action. Create and maintain compliance materials and documentation to demonstrate compliance program effectiveness including the development compliance metrics, benchmarks, and tracking reports. Maintain a strong working knowledge of applicable regulatory guidelines to be viewed as a credible resource for the compliance department and company. Perform other duties and special projects as assigned. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Occasionally 0-30% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Occasionally 0-30% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Occasionally 0-30% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

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