Healthcare Compliance Specialist Job at PRISM Vision Group, New Providence, NJ

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  • PRISM Vision Group
  • New Providence, NJ

Job Description

Role and Responsibilities

Assist the Director of Compliance with-

  • Coordinating the compliance training program, including appropriate introductory training for new staff as well as annual compliance training for all PRISM staff.
  • The investigation of HIPAA incidents.
  • Maintaining the existing language assistance program and Implementing the PRISM language assistance program for integrations with new affiliates, including training.
  • Monthly OIG Exclusions/Sanctions Searches, including investigating potential matches and ruling them out.
  • Due Diligence and Integrations projects during PRISM joint ventures, acquisitions, and the like.
  • Coordination of the legal request for medical record requests process, including determining whether it is appropriate to approve the requested medical records.
  • Providing educational support to staff as needed.
  • Investigating Compliance Hotline concerns.
  • Assisting with maintenance of compliance applications and other databases as needed.
  • Other general duties as assigned.

Education, Training and Experience

  • 3-5 years of healthcare compliance experience.
  • Bachelor's degree or equivalent experience in a compliance role.
  • Compliance certification from HCCA, AAPC, or the like strongly preferred but not required.
  • Proficiency in or experience with healthcare compliance including The HIPAA Rule, HITECH, federal False Claims Act, Anti-kickback Statute, Fraud Waste and Abuse laws, and other healthcare compliance laws.

Knowledge and Skills & Expected Competencies

  • Detail-oriented and organized.
  • Effective oral and written communication skills.
  • Strong research skills.
  • Strong organizational skills.
  • Proficient in Microsoft Office Suite software including Word and Excel.
  • Basic understanding of CMS requirements.
  • Ability to stay current with the healthcare regulatory environment including regulatory changes.
  • Ability to deal effectively with individuals at all organizational levels, working independently and/or with teams.
  • Ability to manage multiple priorities and workflow at one time.

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