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Corporate Compliance Program Coding Manager - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Cleveland, OH Cleveland, Ohio |
About this job
Job Summary:
Manages and coordinates activities related to compliance with Federal, State, and local laws, regulations, internal policies and procedures, and professional ethics, related to main campus or the regional hospitals.
Responsibilities:
* Assists the Director with developing and administering the CC Compliance Program.
* Facilitates annual risk assessments by responsible CC departments, Institutes and/or hospitals and performs gap analysis.
* Monitors compliance with policies and action plans and measures effectiveness of the Program.
* Assists Director with developing or revising policies and procedures to comply with changes in the law or regulations as necessary and appropriate.
* Receives compliance complaints and inquiries and ensures all compliance matters are appropriately investigated.
* Assists in preparing formal responses to governmental or other regulatory audits and inquiries.
* Maintains accurate documentation of all complaints, investigative findings, corrective actions and final resolutions.
* Promptly informs Director or Chief Integrity Officer (CIO) of any matter warranting their attention.
* Works directly with Institute, Department, or Hospital compliance representatives, providing technical assistance as needed to develop, implement and maintain effectiveness of their respective Compliance Programs.
* Assesses compliance education needs for the CC workforce and develops content and curriculum of compliance training.
* Maintains current knowledge of compliance laws, regulations and trends.
* Assures timely training of new workforce members and periodic re-training of the workforce and maintains documentation of same.
* Other duties as assigned.
Education:
* Bachelor's degree from an accredited college or university or equivalent experience in healthcare or finance field.
* Graduate degree preferred.
Certifications:
* Preferred candidates will be certified in one of the healthcare compliance disciplines, licensed as a Registered Nurse (RN), or to practice law in the State of Ohio.
Complexity of Work:
* Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
* Must be able to work in a stressful environment and take appropriate action.
Work Experience:
* A minimum of three years recent experience in healthcare compliance, billing, coding, reimbursement, clinical trials research, and/or information management required.
* Three years direct experience and knowledge of Federal, State, and local healthcare laws and regulations.
* Ability to apply laws and regulations within healthcare operations.
* Ability to work with all levels within the organization on compliance issues arising through the CC Compliance Program.
* Strong written and oral communication skills, particularly with patients, governmental and other regulatory agencies, business associates or others.
* Project management experience and an excellent understanding of root cause analysis or process improvement is desired.
Physical Requirements:
* Requires dexterity to operate office equipment and the ability to walk to parts of various hospital campuses to attend meetings.
* Must have normal or corrected vision, and the ability to verbally communicate to upper level management.
* Occasional lifting of up to 25 pounds.
Personal Protective Equipment:
* Follows standard precautions using personal protective equipment as required.
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities
Manages and coordinates activities related to compliance with Federal, State, and local laws, regulations, internal policies and procedures, and professional ethics, related to main campus or the regional hospitals.
Responsibilities:
* Assists the Director with developing and administering the CC Compliance Program.
* Facilitates annual risk assessments by responsible CC departments, Institutes and/or hospitals and performs gap analysis.
* Monitors compliance with policies and action plans and measures effectiveness of the Program.
* Assists Director with developing or revising policies and procedures to comply with changes in the law or regulations as necessary and appropriate.
* Receives compliance complaints and inquiries and ensures all compliance matters are appropriately investigated.
* Assists in preparing formal responses to governmental or other regulatory audits and inquiries.
* Maintains accurate documentation of all complaints, investigative findings, corrective actions and final resolutions.
* Promptly informs Director or Chief Integrity Officer (CIO) of any matter warranting their attention.
* Works directly with Institute, Department, or Hospital compliance representatives, providing technical assistance as needed to develop, implement and maintain effectiveness of their respective Compliance Programs.
* Assesses compliance education needs for the CC workforce and develops content and curriculum of compliance training.
* Maintains current knowledge of compliance laws, regulations and trends.
* Assures timely training of new workforce members and periodic re-training of the workforce and maintains documentation of same.
* Other duties as assigned.
Education:
* Bachelor's degree from an accredited college or university or equivalent experience in healthcare or finance field.
* Graduate degree preferred.
Certifications:
* Preferred candidates will be certified in one of the healthcare compliance disciplines, licensed as a Registered Nurse (RN), or to practice law in the State of Ohio.
Complexity of Work:
* Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
* Must be able to work in a stressful environment and take appropriate action.
Work Experience:
* A minimum of three years recent experience in healthcare compliance, billing, coding, reimbursement, clinical trials research, and/or information management required.
* Three years direct experience and knowledge of Federal, State, and local healthcare laws and regulations.
* Ability to apply laws and regulations within healthcare operations.
* Ability to work with all levels within the organization on compliance issues arising through the CC Compliance Program.
* Strong written and oral communication skills, particularly with patients, governmental and other regulatory agencies, business associates or others.
* Project management experience and an excellent understanding of root cause analysis or process improvement is desired.
Physical Requirements:
* Requires dexterity to operate office equipment and the ability to walk to parts of various hospital campuses to attend meetings.
* Must have normal or corrected vision, and the ability to verbally communicate to upper level management.
* Occasional lifting of up to 25 pounds.
Personal Protective Equipment:
* Follows standard precautions using personal protective equipment as required.
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities