Compliance Officer

Description

• Inform management and employees of the rules they need to follow to prevent irregularities and contribute to implementing an adequate compliance program by educating the personnel on compliance matters.

• Communicate with government agencies and contractors to ensure Agency operations comply with laws and its Compliance Program.

Reporting Relationship

• Reports directly to the Manager.

Responsibilities/Activities

• Oversee and manage Agency’s Compliance Program, which adheres to Federal and State standards, with rigid focus on anti-fraud and anti-abuse measures.

• Keep Compliance Program active and focused on its goals.

• Develop policies and procedures for reporting suspected fraud without fear of retaliation.

• Monitor billings to Medicaid for fraud, abuse and/or false claims practices:

 Keep current with healthcare compliance regulations to ensure the Agency’s procedures adhere to the necessary rules.

 Implement compliance policies, processes, and codes of conduct to prevent legal liability

 Establish efficient compliance plans to ensure client records, billing methods, and other sources of personal client data are kept confidential.

• Review Agency’s records and record transfer procedures to recommend improvements to its record-keeping system.

• Investigate compliance violations, respond promptly, and recommend corrective actions.

• Monitor the effectiveness Compliance Program and submit reports to Performance Improvement Coordinator, which identify areas of compliancy & non-compliancy in accordance with Agency policies and federal, state and other jurisdictional regulations.

• Report violations to the False Claims Act, federal, state or other jurisdiction law and Agency policy/ Standards of Conduct to the Performance Improvement Coordinator/Manager.

• Ensure required audits are conducted and submitted to the Program Improvement Coordinator.

• Assist with the coordination of internal compliance reviews to manage the Agency's financial activities.

• Provide employee compliance training to raise staff awareness of legal issues.

• Follow best practices to help minimize the risk of healthcare data breaches.

• Communicate with Independent Contractors to ensure all services are provided in accordance with the Compliance Program.

• Submit non-compliance reports to Program Improvement Coordinator for inclusion in Quarterly Activity Reports and to Governing Body and/or Compliance/Ethics Committee, as relevant.

Required Knowledge

• Knowledge of health care policies.

• Knowledge of medical ethics.

• Knowledge of quality assurance techniques.

• Knowledge of written and verbal communication techniques.

• Knowledge of analytical reasoning techniques.

• Knowledge of problem-solving techniques.

• Knowledge of prioritizing techniques.

Required Education

• Bachelor’s degree in Healthcare, Nursing, Healthcare Administration, Business Administration, Law, or a related field.

• 2 years of experience in Healthcare Compliance, Management, or Operations.

• Thorough knowledge of healthcare legislation.

• Clear understanding of the financial aspects of the healthcare industry.

• Excellent analytical and communication skills.

Job Type: Part-time

Pay: $22.65 - $23.39 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance

Experience:

• Microsoft Powerpoint: 1 year (Preferred)

Ability to Commute:

• Springfield, MA 01115 (Preferred)

Ability to Relocate:

• Springfield, MA 01115: Relocate before starting work (Required)

Work Location: In person

Salary : $23 - $23