Description

HEALTHCARE COMPLIANCE COORDINATOR JOB SUMMARY

This position primarily provides administrative support to the CAO and serves as CCHC’s Privacy Officer. The individual will work as a liaison between Comprehensive Community Health Centers (CCHC) and its contracted IPAs and health plans, reviews and supports implementation of regulatory guidance or laws, and supports all areas of Compliance.

Healthcare Compliance Coordinator Essential Duties And Responsibilities

• Provides administrative support to the CAO.
• Develops and maintains positive relationships with IPAs and health plans by conducting over-the-phone and on-site meetings, and leading joint operating committee (JOC) meetings with IPA and health plan representatives on a regular basis.
• Addresses operational issues between CCHC and IPAs and health plans regarding claim submissions, authorization issues, provider contracting issues, credentialing issues, and other issues as directed.
• Maintains IPA and Plan contracts.
• Maintains provider and vendor contracts.
• Maintains all internship, externship, volunteer agreements with educational institutions and programs
• Remains current and up to date on IPA, health plan and other state and federal legislation, including HRSA requirements, impacting CCHC. Includes but is not limited to interpreting guidelines, disseminating information to other CCHC Department Heads and providers, training staff on new requirements, and developing policies and procedures to support new or changing requirements.
• Ensures adherence with federal and state regulations and accreditation standards.
• Responsibilities also include operating, overseeing, and modifying CCHC’s Compliance Program, and internal monitoring of CCHC operations for compliance purposes.
• Responsible for working with legal counsel, when directed by CAO.
• Establishes and maintains required language, contract provisions and terms for all agreements entered into by CCHC
• Identify information security, confidentiality and release of patient information/HIPAA issues.
• Serves as CCHC’s Privacy Officer
• Provide administrative support to Compliance Department, including preparation for the Board of Directors quarterly Compliance Committee meeting.
• Coordinates with CCHC’s Credentialing Department and periodically assists the Revenue Cycle (Billing) Department with auditing and troubleshooting of provider data to ensure proper claims adjudication
• Performs other duties as assigned or requested.
  
  

Requirements

HEALTHCARE COMPLIANCE COORDINATOR EDUCATION AND EXPERIENCE

• Health Resources and Services Administration (HRSA) experience desired.
• Bachelor’s degree in Business Administration, Health Care Administration or other-related field required.
• 3-5 years-experience in a health care setting preferred.
• General knowledge of state and federal legislation specific to the healthcare field.
• Paralegal or contracting experience is desired but not required.
  
  

HEALTHCARE COMPLIANCE COORDINATOR PAY RATE: $33-$36/hr

Healthcare Compliance Coordinator Benefits

• Medical, Dental and Vision – 100% paid by Employer
• Life Insurance and Accidental Dismemberment – 100% paid by Employer
• Paid Holidays
• Paid Time Off
• 401K
• 401K Matching
• Flexible Spending Account
• Fringe
• Supplemental Insurance
  
  

PHYSICAL DEMANDS

Position requires prolonged sitting at a computer, some bending, lifting, stooping and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopy machine, telephone, and other office equipment is also required. Employee must have normal range of hearing and eyesight.

NOTE: The essential job functions for this position include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential functions of this job without imposing significant risk of substantial harm to the health or safety of themselves or others