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Compliance Specialist

Req #:  111952
Facility:  Support Centers
Department:  Compliance/Legal
City:  Downers Grove
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Advocate Health Care, the largest health system in Illinois and one of the largest health care providers in the Midwest. Our Corporate Support & Operations Services are equally committed to advancing Advocate's goal of building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

Purpose:
Supports the Compliance Department with the facilitation and administration of compliance activities related to the operation of the compliance program. Performs reviews, research, data analysis and investigations, tracks and analyzes compliance activities, and prepares compliance and regulatory educational materials.

Accountabilities:

  • Contributes to the development, maintenance, and updating of an annual compliance review plan.
  • Conducts compliance reviews and investigations, including design and documentation of the review/investigatory methodology. Oversees ongoing compliance monitors already in place.
  • Performs data collection for investigations of potential compliance issues, and for other compliance activities such as conflict of interest disclosures, risk assessments, surveys, etc. Uses analytical review, computer analytics and statistical sampling techniques to identify compliance risk areas.
  • Collaborates with various departments to obtain information needed in conducting reviews, risk assessments, and investigations and performs tracking and follow~up to ensure all information has been received. Prepares reports of audits, reviews and investigations. Facilities corrective action in departments throughout the organization to promote compliant practices and processes.
  • Partners with Compliance Officers and department leadership throughout the organization to establish ongoing compliance monitors and reports as needed. Performs follow~up activities to ensure corrective action plans have been implemented and maintained.
  • Prepares and delivers education related to the results of reviews, investigations, and on general and specific compliance topics.
  • Prepares and delivers quarterly reports for compliance committees regarding the compliance review activities and actions taken, and creates reports for regulatory agencies as directed.
  • Performs research related to regulatory requirements. Functions as a knowledgeable resource for identification

 

Position Requirements:

  • Bachelor's Degree in Health Information Management or related field.
  • Typically requires 3 years of experience in a health care environment that includes experiences with health care regulatory requirements.
  • Working knowledge of compliance related regulations such as coding, billing, documentation requirements, Local and National Coverage Decisions, National Comprehensive Coding Initiatives, Medicare/Medicaid billing regulations, the HIPAA Privacy Rule, etc.
  • Strong computer, problem~solving and analytical skills, including ability to perform data mining to identify aberrant patterns that may be indicative of compliance issues or trends.
  • Highly motivated, team oriented, professional and trustworthy, with strong skills in personal diplomacy.
  • Presentation and writing skills to prepare and organize media for delivery of reports and education to physicians, leadership, and staff.
  • Demonstrated ability to handle sensitive communications with leadership, physicians, management, and legal counsel.
  • Experience with maintaining confidentiality of patient and business information.
  • Strong organizational and time management skills.
  • Demonstrated proficiency in the Microsoft office (Word, Excel, PowerPoint, Access) or similar products.
  • None Required. Must be able to drive to various sites so therefore will be exposed to weather and road conditions.
  • Operates all equipment necessary to perform the job.
  • Exposed to normal office environment.
  • This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

About Advocate Health Care

 

Advocate Health Care, named among the nation’s Top 5 large health systems based on quality by Truven Analytics, is the largest health system in Illinois and one of the largest health care providers in the Midwest. Advocate operates more than 250 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, the state’s largest emergency and Level I trauma network, one of the area’s largest home health care companies, and the region’s largest medical group. Advocate Health Care has 4 teaching hospitals and is a not-for-profit, mission-based health system affiliated with the Evangelical Lutheran Church in America and the United Church of Christ.


Nearest Major Market: Chicago