Compliance Specialist jobs in Middlesex, NJ

Role and Responsibilities

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 PRISM staff.
• The investigation of HIPAA incidents.
• Maintaining the existing language assistance program and Implementing the PRISM language assistance program for integrations with new affiliates, including training.
• Monthly OIG Exclusions/Sanctions Searches, including investigating potential matches and ruling them out.
• Due Diligence and Integrations projects during PRISM joint ventures, acquisitions, and the like.
• Coordination of the legal request for medical record requests process, including determining whether it is appropriate to approve the requested medical records.
• Providing educational support to staff as needed.
• Investigating Compliance Hotline concerns.
• Assisting with maintenance of compliance applications and other databases as needed.
• Other general duties as assigned.

Education, Training and Experience

• 3-5 years of healthcare compliance experience.
• Bachelor’s degree or equivalent experience in a compliance role.
• Compliance certification from HCCA, AAPC, or the like strongly preferred but not required.
• Proficiency in or experience with healthcare compliance including The HIPAA Rule, HITECH, federal False Claims Act, Anti-kickback Statute, Fraud Waste and Abuse laws, and other healthcare compliance laws.

Knowledge and Skills & Expected Competencies

• Detail-oriented and organized.
• Effective oral and written communication skills.
• Strong research skills.
• Strong organizational skills.
• Proficient in Microsoft Office Suite software including Word and Excel.
• Basic understanding of CMS requirements.
• Ability to stay current with the healthcare regulatory environment including regulatory changes.
• Ability to deal effectively with individuals at all organizational levels, working independently and/or with teams.
• Ability to manage multiple priorities and workflow at one time.   

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