Senior Compliance Specialist

Overview

Position

Purpose:

Contributes to the fulfillment of the Renown Health purpose by promoting a culture of ethical and compliant behaviors and practices accomplished through planning, coordinating, implementing and maintaining a system-wide compliance program as part of the Renown Health Corporate Compliance Program. The compliance program serves as the primary resource regarding issues related to federal and state regulations such as HIPAA, EMTALA, the False Claims Act, Stark Law, the Anti-Kickback Statute, and CMS coding and billing requirements, playing a vital role in protecting the organization’s integrity and maintaining compliance with healthcare standards.

In collaboration with the Internal Audit Department, this role also supports projects related to compliance risk assessments, compliance audit and self-monitoring programs, and compliance audits conducted by independent outside firms.

This position is responsible for identifying and assessing areas of compliance risk; assisting with the development and implementation of compliance training and education programs; serving as a point of contact for Renown Health or Hometown Health employees regarding potential compliance concerns and questions; researching federal and state regulations; monitoring and communicating regulatory changes that impact Renown Health and delegated entities; and supporting compliance leadership in timely detection, response, investigation, analysis and applicable corrective action pertaining to any compliance matter.

The Senior Compliance Specialist may chair or co-chair the various Compliance Committees. The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. The responsibilities of this position may include the performance of other duties.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Education

• Must have working-level knowledge of the English language, including reading, writing, and speaking English. A Master’s in Healthcare or Business Administration is preferred. Educational requirements may be waived if extensive working experience is demonstrated.

Experience

• 5-10 years of health care billing or regulatory experience. Preference will be given to those applicants with experience in more than one setting (i.e. skilled nursing facilities, acute hospital, home health, physician office, health plan, etc.) and/or clinical experience.

License(s)

• Ability to obtain and maintain a valid State of Nevada driver’s license and ability to pass Renown Health's Department of Motor Vehicle Report criteria.

Certification(s)

• Must possess and maintain at least one of the following certifications and obtain a second listed certification within the first year of employment CHC (Certified in Healthcare Compliance), CHPC (Certified in Healthcare Privacy Compliance), CHRC (Certified in Healthcare Research Compliance) CCEP (Certified Compliance and Ethics Professional), CPC (Certified Professional Coder), CIC (Certified Inpatient Coder) or another certification approved by leadership.

Computer / Typing

• Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.