Corporate Compliance Specialist

  • Exeter, NH
  • Exeter Hospital
  • Finance
  • full time
  • Req #: 7442
  •  Day Shift - Monday through Friday; 8:00 am - 5:00 pm
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Summary

Supports all aspects of Exeter Hospital's Integrity and Compliance Program to include: (1) researching documentation coding and billing requirements (2) conducting investigations audits and monitoring of internal processes and controls to ensure compliance with applicable statutory and regulatory requirements and organizational policies; (3) educating management clinicians and staff; and (4) providing guidance and assistance to hospital departments in operationalizing statutory and regulatory requirements.

Requirements:

  • Bachelor's Degree or equivalent experience with clinical background and experience preferred
  • 3-5 years experience in hospital inpatient and outpatient coding/auditing/compliance program implementation
  • Effective oral and written communication skills
  • Excellent skills in Microsoft Word and Excel
  • At least one of the following:  Certified Professional Coder (CPC/CPC-H), Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT)

Major Responsibilities:

  1. Conducts investigations; audits and monitoring of internal processes and controls to ensure compliance with applicable statutory and regulatory requirements. Prepares reports of investigations; audits and monitoring with clear and concise findings and recommendations.
  2. Researches and provides guidance concerning documentation; coding and billing requirements. Acts as a resource to physicians; non-physician providers; support staff; administrators and other personnel concerning the interpretation and implementation of Medicare; Medicaid and other third party payer documentation; coding and billing requirements.
  3. Creates a working relationship with clinicians; management and staff to promote the effectiveness of Exeter Hospital's Integrity and Compliance Program. Acts as a bridge between the Finance Department and clinical areas to operationalize statutory and regulatory requirements and organizational policies and coordinate the implementation of remedial measures; when necessary.
  4. Provides ongoing education and training to support the effectiveness of Exeter Hospital's Integrity and Compliance Program.
  5. Maintains tracking systems for compliance related issues and assists in preparing reports on the status of investigations; findings; and remedial measures.
  6. Assists Compliance Officer with other activities that support all aspects of Exeter Hospital's Integrity and Compliance Program as necessary.
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