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Compliance Program Specialist

Professional Compliance Auditor and educator expected to adhere to coding practice guidelines in accordance to the Standards of Ethical coding set forth by the American Health Information Management (AHIMA), attachment for production of quality healthcare data.
Professional Compliance Auditor and educator expected to perform all coding and education function proficiently, accurately and completely to facilitate the billing process and identify areas for compliance education.
Essential Functions:
Oversee compliance auditing and monitoring programInitiates and performs periodic reviews of the billing/coding processProvide coding expertise to physicians for all compliance issuesDevelop educational materials related to documentation, compliance and reimbursement for physicians and coding/billing staff.
Attend meetings independently to deliver the training and materials to physicians and departments on an as needed basis.
Conduct educational in-services for all specialty physicians and coding/billing staff.
Analyze and report coding issues/questions from both a compliance and reimbursement perspective.
Develop summary reports monthly, quarterly and annually of compliance audit findings.
Meet with Executive, Chairs and Directors to communicate and discuss compliance program and audit findings.
Prepare written report of the compliance program activities to the Compliance Officer.
Provide physician new hire orientation to review and discuss compliance program, code of conduct, conflicts of interest, and HIPAA plan.
Maintains detailed understanding of regulatory requirements related to government and commercial coding practices and guidelines and provides updates and education to the City of Hope Foundation regarding these requirements.
Performs other related duties as assigned or requested.
Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan.
Practices a high level of integrity and honesty in maintaining confidentiality.
The following shared, organization-wide competenciesdescribe the desired behaviors that will facilitate success at City of Hope:
Communication - Expresses ideas clearly and constructively (written and spoken, upward and downward, one-on-one and with groups).
Customer Service - Seeks to understand customer needs and works to exceed customer expectations (internal and external).
Initiative - Looks for opportunities to improve performance; manages time, work, and relationships effectively and efficiently.
Professionalism - Treats others with respect; abides by the institutional values; displays a positive and cooperative attitude; adheres to the workplace Code of Conduct and compliance policies.
Stewardship - Identifies efficiencies to reduce redundancy and/or elimination of tasks resulting in savings of cost, resources, and or/time.
Teamwork - Works proactively and collaboratively with others to streamline work and achieve mutual goalsPosition Qualifications:
Minimum EducationBachelor's degree or equivalent work experienceMinimum ExperienceMinimum of three years of proven work experience as a coder and in delivering training to physicians.
License/CertificationOne or more of the following coding certifications:
Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Preferred EducationICD-10 CertifiedRegistered Health Information Technician (RHIT)Aptitude:
Req/PrefAbility to teach and trainAbility to interact with providers and staff at various departments and at various levels within the organization.
About City of HopeCity of Hope, an innovative biomedical research, treatment and educational institution with over 4000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.
Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research.
City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation's 20 leading cancer centers that develops and institutes standards of care for cancer treatment.
City of Hope strongly supports and values the uniqueness of all individuals and promotes a work environment where diversity is embraced.
Equal Opportunity / Affirmative Action Employer.
City of Hope is an equal opportunity employer.
All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, or status as a qualified individual with a disability.


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