What are the responsibilities and job description for the Compliance Specialist | Compliance | FT position at UF Health?
Overview
UF Health Spanish Plaines Hospital, formerly known as The Villages Regional Hospital and acquired by University of Florida Health in January 2020, has been serving residents of The Villages as well as patients in Lake, Sumter and Marion counties since 2002. At UF Health The Villages® Hospital, we are committed to providing the community with leading-edge patient care, clinical training and research programs. Our teams of physicians and clinical staff work together to offer specialty services, advanced technology and clinical studies - bringing world-class health care closer to you and your loved ones.
We are part of UF Health Central Florida, a not-for-profit health care system and the largest most comprehensive provider of health care services in the region. UF Health Central Florida provides inpatient acute hospital services at UF Health Spanish Plaines Hospital and UF Health Leesburg Hospital, inpatient rehabilitation services at UF Health Rehab Hospital - The Villages and diagnostic laboratory services at several locations. We take pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve.
Responsibilities
To provide ongoing compliance monitoring and auditing functions for a multi-hospital healthcare system to include review of regulatory, audit, billing, coding, documentation, medical necessity and other general compliance processes and analyses that result in appropriate reimbursement for the hospital and adherence to applicable laws, rules, guidelines and regulations. Provides ongoing compliance education and training. Researches and responds to compliance inquiries. Follows investigation protocols and responds to reported, suspected, or confirmed non-compliance. Participates in and attends compliance meetings that foster open lines of communication within the organization. Assists in the development and monitoring of special compliance projects with Compliance Managers and members of hospital departments. Provides compliance advice and guidance.
Qualifications
Minimum Education and Experience Requirements:
Bachelor's degree and 2 years compliance, clinical, coding, auditing, legal, or related work experience;
OR
Associate's degree in a health or business-related field and 4 years compliance, clinical, coding, auditing, legal, or related work experience;
OR
certifications in Compliance, Coding and/or Auditing, and 6 years compliance, clinical, coding, auditing, legal, or related work experience with knowledge of and experience with healthcare laws and regulations that govern hospitals and/or the health care industry. CHC (Certified in Healthcare Compliance) credential is required.
Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred. Must be knowledgeable of Medicare, Medicaid, state and federal laws and regulations governing the healthcare industry. Ability to research and understand complex regulations is required. Proven ability to problem-solve is essential. Skill with MS Office tools (including Excel, Word, and Power Point) is required. Must be organized, versatile, and able to work independently. Motor Vehicle Operator Designation: Employees in this position: Will operate vehicles for an assigned business purpose as a non-frequent driver
Licensure/Certification/Registration
Certification in Healthcare Compliance (CHC) can be obtained within 12 months of hire or transfer into the department.
RN, LPN, RHIA, RHIT, CPC-H/COC, CPC, or CCS preferred.
UF Health Spanish Plaines Hospital, formerly known as The Villages Regional Hospital and acquired by University of Florida Health in January 2020, has been serving residents of The Villages as well as patients in Lake, Sumter and Marion counties since 2002. At UF Health The Villages® Hospital, we are committed to providing the community with leading-edge patient care, clinical training and research programs. Our teams of physicians and clinical staff work together to offer specialty services, advanced technology and clinical studies - bringing world-class health care closer to you and your loved ones.
We are part of UF Health Central Florida, a not-for-profit health care system and the largest most comprehensive provider of health care services in the region. UF Health Central Florida provides inpatient acute hospital services at UF Health Spanish Plaines Hospital and UF Health Leesburg Hospital, inpatient rehabilitation services at UF Health Rehab Hospital - The Villages and diagnostic laboratory services at several locations. We take pride in providing progressive, innovative technology, along with building strong relationships with patients, families, physicians and residents of the communities we serve.
Responsibilities
To provide ongoing compliance monitoring and auditing functions for a multi-hospital healthcare system to include review of regulatory, audit, billing, coding, documentation, medical necessity and other general compliance processes and analyses that result in appropriate reimbursement for the hospital and adherence to applicable laws, rules, guidelines and regulations. Provides ongoing compliance education and training. Researches and responds to compliance inquiries. Follows investigation protocols and responds to reported, suspected, or confirmed non-compliance. Participates in and attends compliance meetings that foster open lines of communication within the organization. Assists in the development and monitoring of special compliance projects with Compliance Managers and members of hospital departments. Provides compliance advice and guidance.
Qualifications
Minimum Education and Experience Requirements:
Bachelor's degree and 2 years compliance, clinical, coding, auditing, legal, or related work experience;
OR
Associate's degree in a health or business-related field and 4 years compliance, clinical, coding, auditing, legal, or related work experience;
OR
certifications in Compliance, Coding and/or Auditing, and 6 years compliance, clinical, coding, auditing, legal, or related work experience with knowledge of and experience with healthcare laws and regulations that govern hospitals and/or the health care industry. CHC (Certified in Healthcare Compliance) credential is required.
Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred. Must be knowledgeable of Medicare, Medicaid, state and federal laws and regulations governing the healthcare industry. Ability to research and understand complex regulations is required. Proven ability to problem-solve is essential. Skill with MS Office tools (including Excel, Word, and Power Point) is required. Must be organized, versatile, and able to work independently. Motor Vehicle Operator Designation: Employees in this position: Will operate vehicles for an assigned business purpose as a non-frequent driver
Licensure/Certification/Registration
Certification in Healthcare Compliance (CHC) can be obtained within 12 months of hire or transfer into the department.
RN, LPN, RHIA, RHIT, CPC-H/COC, CPC, or CCS preferred.
