What are the responsibilities and job description for the Compliance Director position at SENTA Partners?
Southern Ear, Nose, Throat and Allergy (SENTA) physicians provide the highest quality allergy, asthma, immunology and otolaryngology care through our network of practices.
SENTA is a leading Management Services Organization (MSO) specializing in providing comprehensive support to ENT and Allergy private practices. Our mission is to help people Breathe better, Hear better, Live better. At SENTA, we focus on the operational efficiencies and financial performance of our partner practices, allowing physicians to focus on delivering exceptional patient care. We are committed to fostering a collaborative and supportive work environment where our employees can thrive and grow.
Compliance Director is responsible for managing activities related to developing, implementing, maintaining, and adhering to policies and procedures in compliance with federal, state, and local healthcare laws and regulations. Compliance Director is responsible for providing guidance to senior leadership team and clinicians on all compliance-related matters, working with outside legal counsels when appropriate to determine risks and action plans and implementing policies and procedures to ensure consistency across the practices.
Major Duties and Responsibilities:
- Oversees and monitors the organization’s compliance program.
- Identifies potential areas of compliance vulnerability and risk by conducting risk analysis; develops/implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
- Reports on a regular basis to the organization’s compliance committee on the activities of the compliance program.
- Revises the compliance program, and at least annually, in response to changes in regulations and in accordance with the needs of the organization
- Serve as a subject matter expert on Billing and Coding compliance and advise company accordingly.
- Leads an internal compliance review, monitoring activities, payor audits, etc.
- Facilitates the internal chart review program.
- Investigates and acts on compliance matters including coordinating corrective actions.
Experience and Education
- Five to ten years of relevant professional experience in healthcare. Experience in medical practice management is preferred.
- Preference for healthcare compliance certification, such as Certified in Healthcare Compliance (CHC) Certificate from the Health Care Compliance Association (HCCA), along with a fundamental understanding of regulatory frameworks and coding practices.
- Preference for privacy certification such as Certified in Healthcare Privacy Compliance (CHPC) from HCCA or Certified in Healthcare Privacy and Security (CHPS) from the American Health Information Management Association (AHIMA); other AHIMA certifications (e.g., Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)) will also be considered.
- Robust working knowledge of managed government healthcare program (i.e., Medicare and Medicaid) requirements and applicable laws and regulations, including those concerning healthcare fraud, waste, and abuse. Demonstrated ability to work effectively with key internal and external stakeholders. Prior experience working with management committees, boards, and governing bodies is preferred.
