Purpose: |
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Under limited supervision, functions as compliance professional that reviews and evaluates compliance issues/concerns within the organization.
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Duties, Functions and Responsibilities: |
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Essential duties and functions, pursuant to the Americans with Disabilities Act, may include the following. Other related duties may be assigned.
- Maintains responsibility for the regulatory review and execution departmental compliance requirements
- Assists Executive management in ensuring processes and staff are in compliance with applicable policies, procedures, rules, and regulations
- Provides guidance to the various operating units in the department.
- Oversees the development and implementation of compliance procedures and systems
- Oversees the confidentiality of information required to be confidential
- Monitors policy and program adequacy and effectiveness.
- Conducts investigations and recommends policy and/or procedure changes
- Develops and maintains a system for uniform handling of compliance results
- Ensures adequate response to all compliance and related helpline calls and contacts
- Identifies potential areas of compliance vulnerability and risk.
- Works with appropriate personnel to develop and effective compliance training program
- Creates and maintains templates for reports, guidelines for documentation, and training materials
- Provides regulation, code, policy and procedure compliance guidance to the approved non-emergency transport providers
- Monitors the department’s performance measures to ensure reporting compliance
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Responsibilities - Supervisor and/or Leadership Exercised: |
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- May provide leadership, work assignments, evaluation, training and guidance to others.
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Knowledge, Skills, and Abilities: |
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Must possess required knowledge, skills, abilities, and experience and be able to explain and demonstrate, with or without reasonable accommodations, that the essential functions of the job can be performed.
- Knowledge of industry practices and processes.
- Knowledge of the medical industry and medical terminology.
- Ability to handle complex situations and think in a systematic manner.
- Ability to multitask and follow through with complex assignments.
- Ability to deal with all personalities and maintain composure under stressful conditions.
- Ability to create ad hoc data mining reports.
- Ability to develop and execute documentation training.
- Knowledge of franchise operations.
- Knowledge of federal regulations
- Knowledge of mobile technologies and computer networking systems.
- Knowledge of electronic documentation processes and workflow.
- Knowledge of Excel, Word, and other numbers/reporting-based software.
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Minimum Qualifications: |
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- Graduation with a Bachelor’s degree from an accredited college or university with major coursework in Business, Engineering or in a field related to the job, plus four (4) years of experience in a field related to the job, 2 of which were in a leadership role in a billing and records management environment, and one of which was in audit and compliance of federal regulations..
- Experience may be substituted for education up to a maximum of four (4) years.
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Licenses and Certifications Required: |
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