The Compliance Officer provides direction and oversight of the Oregon Imaging Centers (OIC) and Radiology Associates (RA) compliance programs, implements, documents, and maintains with the goal of sustaining compliance with all laws, regulations, and policies that govern billing for healthcare services. The Officer reports to the Administrator of OIC, RA, and the Board of Directors, as it is a dual organizational role.
- Participates as a member of OIC and RA senior leadership team.
- Administers the Compliance programs, in conjunction with PeaceHealth and RA compliance programs, to support compliance activities throughout the organizations.
- Directs and oversees efforts to communicate compliance standards, awareness, and education related healthcare compliance; periodically reviews and revises, as necessary, the Compliance Program’s core training materials; and provide updates and information describing regulatory developments.
- Revises, develops, and maintains policies and procedures that establish standards for compliance related to healthcare services.
- Will have a strong working knowledge of Medicare, Medicaid and commercial reimbursement processes, including documentation, coding, auditing, appeals and denial processes, as well as extensive familiarity with Dept. of Health and Human Services Office of Inspector General and Centers of Medicare and Medicaid rules, regulations and compliance guidance.
- Develops productive working relationships with all levels of management. Demonstrates the ability to listen, understand and educate others. Manages and tracks all issues referred to the Compliance Office.
- Works with leaders to ensure management and employees are in compliance with state and local laws and regulations (Stark Law, False Claims Act, HIPAA, Anti-Kickback Statute and associated penalties).
- Coordinates as appropriate with outside legal counsel, conducting or authorizing and overseeing investigations of matters that merit investigation.
- Create and monitor Business Associate Agreements to ensure that all Business Associates are maintaining privacy requirements and responsibilities.
- Identifies potential areas of compliance vulnerability and risk, develops and implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
- Oversees the Company Policy Database and update policies as needed.
- Performs other duties as assigned.
Education/Experience:
- Bachelor's degree; or equivalent knowledge and skills obtained through a combination of education, training, and experience preferred.
- A minimum of 3 years healthcare operations experience including auditing, monitoring, investigating and/or compliance/privacy required.
- Working knowledge and experience with HIPPA.
Certification:
Certification in one of the following, must obtain one of the below certifications within 24 months from hire date if not obtained at time of hire:
- Certification in Healthcare compliance (CHC)
- Certification in Healthcare Privacy Compliance (CHPC)
- Certification Information Privacy Professional (CIPP/US)
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must have the ability to tolerate long periods of sitting and/or standing, walking; climb stairs; use a keyboard with sufficient dexterity for speed required by job; read computer screen (at times for extended periods); lift supplies weighing up to 40 pounds (with assistance as necessary); lift, pull, push and manipulate to assist patients of various sizes and weights (with assistance or lifting equipment, as necessary); hear and speak with individuals in person or on the telephone. Specific vision abilities required by this job include close vision, and distance vision.
Job Type: Full-time
Pay: $80,000.00 - $120,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- AD&D insurance
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- Day shift
- Monday to Friday
Ability to commute/relocate:
- Eugene, OR 97401: Reliably commute or planning to relocate before starting work (Required)
Education:
- High school or equivalent (Required)
Experience:
- Medicare: 1 year (Required)
- Compliance management: 1 year (Required)
Work Location: One location