The Compliance Manager establishes and implements an effective compliance program to ensure regulatory compliance
within the medical practice. The Compliance Manager will monitor and report results of compliance efforts of the company and provide guidance for the senior management team. The manager will work closely with department managers, the business office, physicians and other departments, acting as a resource for all compliance issues.
Essential Job Duties
Maintains and enforce our Compliance Plan.
Manage PQRS, Meaningful Use and other government-initiated regulatory programs.
Work directly with the billing office to evaluate and assess the risks associated with business processes, including coding and billing, regulations, policies and procedures, and monitor compliance to all statutory, regulatory and industry standard requirements.
Periodically review and update the Compliance Plan, and provide guidance to management and employees.
Coordinate chart audits with insurance companies.
Coordinate internal audits, develop audit reports, and report findings to CEO.
Provide technical and regulatory guidance to physicians, managers and staff on compliance issues.
Collaborates with other departments as needed to manage compliance issues.
Consults with counsel as needed to resolve difficult legal compliance issues.
Implement and maintain compliance training program.
Performs other duties as assigned.
Bachelor’s Degree in Business or Health Care Administration and one of the following certifications – Certified
Professional Coder (AAPC); Certified Health Care Compliance or equivalent combination of education, expertise
Licensed Medical background preferred (i.e. RN, etc.)
2+ Years in a compliance role within a healthcare facility
Familiarity with healthcare laws, regulations, and standards
Ability to build rapport with physicians and staff
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