Compliance Associate

Job Description

Essential Functions:

• Maintains, monitors, and enforces the Standards of Conduct and Corporate Integrity Program.
• Aids ACO and Senior Compliance Associate(s) in compliance program effectiveness initiatives.
• Develops, implements, and communicates policies and procedures, changes to policy, regulations, and guidelines, and participates in the creation and presentation of educational materials for key topics.
• Maintains channels for reporting compliance concerns, conducts investigations, and monitors for follow-up and recommendations.
• Analyzes compliance concerns, questions, complaints from internal customers and assists in resolving more complex inquiries.
• Serves on key committees throughout the organization, providing guidance on potential compliance concerns, and serving as a liaison to departments with compliance-related responsibilities.
• Establishes and maintains working relationships with key individuals and departments.
• Develops a working knowledge of compliance aspects and attends appropriate educational opportunities to stay updated on relevant compliance topics.
• Maintains awareness of changes to regulations, statutes, and governmental guidance that may impact the organization.
• Assists in the maintenance of revenue cycle controls and processes to ensure appropriate billing and payment.
• Assists with ensuring the timely refund of necessary paybacks.
• Supports the effective and efficient operation of the Conflict of Interest (COI) program, including reviewing disclosures, investigating, reviewing conflict concerns, and developing conflict management plans.

Education Requirement

Juris Doctorate, required. Healthcare compliance certification, preferred.

Skills

• Effective interpersonal and communication skills to collaborate with all levels within the organization.
• Excellent organizational and analytical skills, attention to detail, and ability to be an objective observer.

Experience

One year of experience in a compliance, regulatory, or legal field, required. Experience with electronic medical records, Internal Classification of Diseases (ICD 10), HCPCS, CPT coding principles and guidelines, preferred.

Physical Requirements

OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Standing, Walking
FREQUENTLY: (none specified)
CONTINUOUSLY: Audible speech, Computer skills, Decision Making, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Benefits

The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet