Compliance Specialist

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Maintains the government payer enrollment process for BJC Health Service Organizations and employed practitioners, ensuring BJC participation in government programs and eligibility for payment. Serves as a regulatory consultant and resource to management and departments at all levels and assists in developing appropriate action plans. Requires a high degree of analytical skills, the ability to work independently, the ability to manage data and multiple database entry, and the ability to maintain confidentiality of sensitive information.

• Coordinates and communicates with appropriate stakeholders to ensure timely awareness of sensitive issues and completion of affected tasks and requests.
• Coordinates with BJC administrators and employed practitioners (including Residents, Fellows, APNs, PAs, Speech/PT/OT Therapists, Psychologists) to ensure BJC participation in government programs – Including completion of all initial enrollments, revalidations, and annual updates.
• Deploys HSO and practitioner databases to ensure accurate and timely reporting of relevant data to federal and state programs, including via transference of key information to state and federal provider enrollment systems (PECOS, eMOMED, IMPACT).
• Possesses, maintains, and accurately acts upon knowledge of federal and state government policies and protocols related to provider enrollment in public programs, e.g., Medicare and Medicaid.
• Engages directly with state and federal agents and agencies, on behalf of BJC, BJC HSOs, and our practitioners, to identify, investigate, and resolve issues related to participation in state and federal programs.

• Associate's Degree

• 2-5 years

• Bachelor's Degree

• 5-10 years

• No Experience

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Pension Plan*/403(b) Plan funded by BJC
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to www.bjctotalrewards.com/Benefits

• Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer