- Job Title: Assoc Director - Compliance
- Job ID: 451714
- Location: Shared Services
- Department: Compliance and Integrity
- Full/Part Time: Full-Time
- Regular/Temporary: Regular
- Shift: Day
- FTE %: 100
- Salary Range Min: $90,800.00
- Salary Range Max: $140,740.00
Assoc Director - Compliance (Job Opening 451714) - Under the general supervision of the Compliance Administrative Director, the Associate Director this position is responsible for assisting in the implementation of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud, Waste and Abuse Plan across the Wexner Medical Center enterprise to ensure compliance with contractual and regulatory requirements. Serves as the liaison between Wexner Medical Center and the Medicare Administrative Contractor, (MAC) and Center for Medicare and Medicaid Services, (CMS) for compliance issues. Develops and implements compliance policies and procedures, compliance training and programs in the areas of billing, coding, and reimbursement. Investigates and resolves compliance problems, compliance issues, questions, or complaints received internally. Provided input and representation on key compliance initiatives, meetings, and committees. Facilitates local (departmental) compliance committees assuring that the committees meet, discuss and act on relevant, pertinent and timely compliance issues for that unit. Coaches Tailored Program managers on creation of annual risk assessments and presentations to Compliance Committee. May serve as project lead on risk areas as assigned. Stays abreast of industry and compliance trends; recommends and implements changes to internal company processes as needed. Prepares reports of findings and makes suggestions to assure appropriate documentation and coding are in place. Educates and trains employees and physicians regarding compliance and regulatory issues. Provides second level review of records and documentation as dictated by the assigned investigation. Performs research, investigate facts, and prepare documents to assist Compliance in providing services to the Medical Center. Supervises 3-6 staff as assigned.
Education and experience
For Hire: Candidate must have 10 years or greater experience with physician group practice or hospital regulatory and compliance knowledge, including tracking, reporting and responding to governmental inquiries. Ten years or greater health care management experience. Ability to analyze complex medical records, paper and electronic, and identify billable services; knowledge of IHIS is a plus. Knowledge of current of International Classification of Diseases ( ICD 10) , HCPCS, CPT coding principles and guidelines. Knowledge of federal, state and payer specific regulations and guidelines. Healthcare Compliance related certification within 1 year of hire. A degree in nursing, medicine or other clinical discipline.