CommonSpirit Health

Senior Compliance Specialist

CommonSpirit Health$90K — $110K *
US-AnywhereRemote
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Nursing or equivalent experience accepted
  • 5+ years in healthcare operations or related fields
  • Certified Health Care Compliance (CHC) credential
  • Registered Health Information Technician (RHIT) certification
  • Registered Health Information Administrator (RHIA) certification
  • Certified Coding Specialist - Physician Based (CCS-P) certification
  • Certified Coding Specialist (CCS) certification

Responsibilities

  • Support the development and maintenance of the compliance monitoring/auditing work plan
  • Utilize data analytics to assess coding and clinical outlier risks
  • Collaborate with functional areas to ensure compliance with coding regulations
  • Assist in the development and maintenance of compliance-related policies and procedures
  • Create educational materials on coding compliance and medical necessity
  • Analyze regulatory reports and trends for management insights

Benefits

  • Comprehensive healthcare benefits
  • Retirement savings plans
  • Continuing education opportunities
  • Flexible work arrangements
  • Professional development support
Full Job Description
Job Summary and Responsibilities

As our Senior Compliance Specialist, you will support the CommonSpirit Health Corporate Responsibility Program by developing, implementing, and maintaining an effective and comprehensive compliance auditing and monitoring program.Every day you will conduct and facilitate compliance audits for acute and non-acute care services, analyze outcomes, communicate findings, and contribute to the ongoing auditing and monitoring efforts across CommonSpirit Health to ensure regulatory adherence.To be successful in this role, you will possess strong analytical and auditing skills, a deep understanding of healthcare compliance regulations, and the ability to effectively communicate findings and proactively support the continuous improvement of our compliance program.

  • Supports CRP leadership in developing, implementing and maintaining the compliance monitoring/auditing work plan. Primary reviews/audits will be focused on coding and medical necessity documentation guidelines. Determines monitoring/auditing procedures to be used including the use of computer-assisted audit techniques.
  • In conjunction with clinical services and other functional groups, utilizes data analytics to develop and assess coding and clinical outlier risks. Monitors government recovery audit efforts for trends and patterns of non-compliance with billing, medical necessity and coding issues affecting acute and non-acute care services.
  • Works closely with Health Information Management (HIM), revenue cycle, legal services group, advocacy and other applicable functional areas to ensure proper interpretation, dissemination and ongoing internal auditing and monitoring of compliance with laws and regulations related to coding compliance and medical necessity.
  • Supports leadership in the development, implementation, maintenance, and evaluation of policies, procedures, tools and templates to address changes in current laws and regulations and/or revisions to current laws and regulations related to coding compliance and medical necessity.
  • Develops education designed to promote understanding of coding compliance and medical necessity issues, laws and regulations and consequences of noncompliance.
  • Analyzes reports, data, and trends to keep management and governance informed of the current regulatory environment impacting coding and medical necessity compliance and the potential impact to CommonSpirit Health.
Job Requirements

Required

  • Bachelors Of Science Nursing or Equivalent experience may be considered in lieu of degree
  • 5 years progressive experience in healthcare operations including clinical, regulatory compliance, risk management, audit, law, or related field.
  • Certified Health Care Compliance (CHC)

  • Registered Health Information Technician (RHIT)

  • Registered Health Information Administrator (RHIA)

  • Certified Coding Specialist - Physician Based (CCS-P)

  • Certified Coding Specialist (CCS)

 

About CommonSpirit Health

CommonSpirit is a nonprofit health care center. They offer community health programs, research programs, virtual care services, and home health programs that address the root causes of poor health, such as access to care, affordable housing, neighborhoods, and a healthy environment.

CommonSpirit Health Careers

Join the dedicated team at CommonSpirit Health, a leader in healthcare innovation and community wellness. CommonSpirit Health offers a range of job opportunities that empower professionals to grow their careers in a supportive and diverse environment.

Explore Career Opportunities

CommonSpirit Health is actively hiring and offers a variety of positions that cater to different skills and career aspirations. From clinical roles to administrative positions, the company provides a platform for growth and professional development.

Experience a Culture of Care and Innovation

At CommonSpirit Health, the culture is grounded in diversity, leadership, and innovation. The team is committed to fostering an inclusive environment where every member’s contribution is valued. CommonSpirit Health leads with a spirit of compassion and a commitment to excellence in healthcare.

Join a Team That Values Diversity and Leadership

CommonSpirit Health believes in the power of diversity and leadership to drive innovation. The company invests in diversity training and leadership development programs, ensuring that all team members are equipped to lead with integrity and empathy.

Internship and Employment Opportunities

For those starting their career, CommonSpirit Health offers internship programs that provide hands-on experience in the healthcare industry. These internships are designed to develop essential skills and offer insights into various aspects of healthcare operations.

Benefits and Growth

Employees at CommonSpirit Health enjoy a comprehensive benefits package that supports both their professional and personal lives. The company is committed to the career growth of its employees, offering numerous opportunities for advancement and professional development.

Networking and Professional Development

CommonSpirit Health encourages networking and continuous learning. Employees have access to a wide range of professional development courses and are encouraged to connect with peers and leaders within the industry to enhance their career prospects.

Applying for a Position

To apply for a position at CommonSpirit Health, candidates should prepare their resume to highlight relevant experience and skills. The hiring process may include an interview to assess compatibility with the company’s values and culture. Interested candidates can explore job listings and submit applications through the CommonSpirit Health Careers portal.

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Explore CommonSpirit Health Careers

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Learn more about CommonSpirit Health
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10,001 employees
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