Compliance Officer

The Compliance Officer (CO) will oversee the day-to-day operations of the compliance program which covers multi-state orthodontic practices. The Compliance Officer as the ability to have a direct impact on the care of patients by leading orthodontic practices as well as driving educational initiatives with direct interaction with the compliance committee and clinical staff throughout the organization. This position will drive compliance initiatives, investigations, compliance reporting for the organization, best practices, and ensure a continued culture of compliance to ensure achievement of the objectives of an effective compliance program.

Essential Functions:

• Oversee the day-to-day operation of the compliance program providing annual compliance plans, reporting results.
• Serves as a liaison between the company and federal and state regulatory agencies and recommends necessary changes across orthodontic practices.
• Establishes and reviews corporate clinical and non-clinical policies and procedures are accurate for handling compliance issues and projects related to corporate governance, compliance with federal and state regulations, conflicts of interest, HIPAA, privacy protection and clinical documentation requirements., ethics, etc.
• Develops compliance plans for responding to potential crisis, performs internal audits across company business units in accordance with compliance regulations, policies, and
• Oversees internal and third-party billing service audit process to ensure compliance with Stark, Anti-kickback, Conflicts of Interest, Fraud, Waste and Abuse, coding, clinical documentation, in compliance with all federal, state, and other relevant laws and regulations.
• Develops and implements compliance training to ensure all employees understand their responsibilities related to compliance topics including ethics, laws, regulations, and company
• Oversees the compliance hotline process, which includes investigation and reporting, follow up, and corrective actions to ensure all issues are raised, investigated, reported, and resolved.
• Performing other duties and responsibilities as

Qualifications and Requirements:

• At least three to five years’ healthcare compliance/regulatory
• Strong knowledge and understanding of health care compliance programs in the area of developing, implementing, and managing compliance programs.
• Background in Medicaid Reimbursement, Fraud and Abuse laws and health care privacy
• Knowledge of compliance with all state, federal information privacy and local laws, rules and

Education:

• A Bachelor’s Degree or equivalent education in a related field of study is
• Compliance Certification and Healthcare Privacy Certification (CHPC)

Skills:

• Proficient use of MS Office applications including Teams, Word, Excel, and
• Strong understanding of HIPAA procedures and
• Ability to manage priorities and
• Excellent verbal and written communication, interpersonal and organizational skills, to present compliance requirements to stakeholders effectively at all levels of the organization.
• Knowledge of laws, legal codes, procedures, and other relevant regulatory

Position Type/Expected Hours of Work:

• This is a full-time Days and hours of work are Monday through Friday. Evening and weekend work may be required as job duties demand.

Travel:

• Travel to the various practice locations including NY, NJ, CT, and PA may be necessary to carry out the duties and responsibilities of the position.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.