The Senior Compliance Specialist conducts compliance reviews, special assignments, and research and advisory projects in order to further ensure compliance with laws and regulations by Ballad Health and its subsidiaries. The Senior Compliance Specialist conducts investigations of suspected and known fraudulent or abusive activities. The Compliance Specialist is responsible for the development of review programs, completion of test work, and report writing, subject to final approval by the Manager of Corporate Audit and Compliance Services.
The Senior Compliance Specialist will frequently interface with Senior Management and other personnel at all levels of the organization. In addition, the Senior Compliance Specialist will have occasional contact with Board Members, legal counsel, consultants, federal, state, and local agencies, vendors, patients, physicians and their staffs, industry peers, and other parties.
This position is project-oriented and not routine; it requires self-motivation, the flexibility to deal with unfamiliar situations, and good organizational and interpersonal skills. Most of the projects are “first-time” assignments. This position requires concentration, close attention to detail, objectivity, resourcefulness, the ability to maintain confidentiality of sensitive information, and the ability to work within specified time budgets.
This is a salaried professional position. This position is governed by standards for the internal auditing profession and compliance professions, which are established by the Institute of Internal Auditors (IIA) and Health Care Compliance Association (HCCA) as set forth in the IIA’s Standards for the Professional Practice of Internal Auditing, the IIA Code of Ethics, and the HCCA’s Code of Ethics for Compliance Professionals.
Ballad Health expects all team members to support the VOS initiative by demonstrating awareness of the VOS system and effectively applying it to his/her work.
Job duties of this position may require access to protected patient information (PHI). The team member will be accountable for appropriate use of the record and compliance with all confidentiality and security policy and procedures related to use, access, and disclosure of PHI.
This position requires a Bachelor’s degree from an accredited college or university preferably in business or healthcare related field. Professional certification from a credentialing body such as AHIMA, AAPC, HCCA is required. [For example, Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), Certified Coding Associate (CCA), Certified Practical Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)].
This position requires a minimum of 3 years coding experience, additionally, experience in third party reimbursement and hospital billing is strongly desired. Familiarity with health care laws/regulations and third party billing/coding knowledge is necessary.
Experience with personal computers required. This would include having a working knowledge of word processing, spreadsheet, and audit software as well as experience with on-line systems.
Please apply online at www.balladhealth.org/careers. Choose Ballad Health Jobs 1.