Compliance Specialist

Position Summary

The Compliance Specialist handles HIPAA compliance, release of information, and HIM documentation analysis to support various clinic and surgery center locations. Reporting to the Director of Compliance, this position is primarily responsible for overseeing the enterprise ROI vendor and managing corporate compliance and privacy activities. Responsibilities include coordinating compliance initiatives, conducting audits, and ensuring adherence to regulatory standards within the organization.

Key Duties and Responsibilities

The key duties and responsibilities of the Compliance Specialist include, but are not limited to:

• Serving as the main point of contact for release of information vendor and troubleshooting any issues as it relates to release of information.
• Coordination of the legal request for medical record requests process, including determining whether it is appropriate to approve the requested medical records.
• Medical Record documentation review as requested to support quality assurance and compliance.
• Assisting with maintenance of compliance applications and other databases as needed.
• 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 staff.
  • The investigation and reporting of compliance and other incidents.
  • Updating and maintaining compliance and HIM related policies and procedures.
  • Providing educational support to staff as needed.
  • Monitoring business activities for compliance when regulations change, support departments, and company strategies to ensure compliance with federal, state, and contractual healthcare requirements.
• Performing other duties as assigned, including functions in health information management

Education/Experience

• Bachelor’s degree or equivalent experience in a compliance role
• Knowledge of Health Information Management (HIM) principles, knowledge of Release of Information laws and statutes, knowledge of HIPAA and patient privacy standards
• At least three (3) years healthcare compliance experience required.
• Knowledge of healthcare related regulations and compliance program best practices, including the HITECH, federal False Claims Act, Anti-kickback Statute, Fraud Waste and Abuse laws, and other healthcare compliance laws
• Familiarity with WA State DOH and CMS regulations required with corporate compliance implementation preferred
• Experience with maintaining confidentiality of patients and business information. Demonstrated ability to handle sensitive communications with physicians, Senior Officers, and other stakeholders, as well as legal counsel
• Compliance certification from HCCA, AAPC, or the like strongly preferred but not required

Knowledge, Skills and Abilities

• Ability to prioritize and organize multiple projects and issues
• Strong research skills
• Detail oriented
• Strong organizational and time management skills
• Ability and confidence to work independently with minimum supervision
• Ability to stay current with the healthcare regulatory environment including regulatory changes

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.