Job description
POSITION DESCRIPTION:
Under the guidance of the Director of Compliance, has primary responsibility for serving as IHA’s resource for Compliance Policies, Compliance Education, Integrity and Privacy. Assists Director of Compliance to ensure compliance with all privacy components of the Integrity and Compliance Program. Actively supports the Privacy Officer with all ongoing activities related to the development, implementation and maintenance of the privacy program for IHA.
Responsible for identifying, assessing, investigating and recommending corrective action for all areas of compliance policies, general Compliance Education, Integrity and Privacy. Assures adherence to all government regulations and accrediting body standards, organizes and implements policies and procedures necessary to support IHA structures and processes. This position will serve as the first point of contact for Compliance issues.
ESSENTIAL JOB FUNCTIONS: The following job functions may not be the responsibility of all Compliance Coordinators. In addition to other Compliance Coordinator responsibilities, some Compliance Coordinators will be assigned work that has more focused responsibilities, such as, but not limited to, those related to suggested corrective action or assessment and recommendations for tasks that optimize workflow.
- Develops, coordinates and administers facility-wide system for policy management.
- Reviews policies and processes to formulate potential for organizational changes and makes recommendations for approval by Director of Compliance. Informs directors of service and department heads regarding occurrences, issues, findings and provides feedback to directors to gain compliance with IHA standards.
- Retains knowledge of current IHA events to recommend appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences.
- Assesses new tasks to optimize workflow; provides suggestions to continually improve processes and the customer experience.
- Manages IHA Compliance Policies and Forms; ensures they are up-to-date and saved according to IHA standards for storage, format and archiving.
- Maintains knowledge and complies with applicable healthcare laws, regulations and standards concerning patient care.
- Collaborates with Director to ensure alignment with privacy compliance programs including policies, practices, investigations and acts as a liaison to the locations.
- Collects, evaluates and distributes relevant data concerning compliance education. Performs proactive analysis of data and follows up to close gaps in education.
- Performs audits of IHA standards, records and education tracking systems. Monitors and manages education-tracking files for IHA classes, meeting presentations and HealthStream coursework.
- Performs monthly audit of assigned Compliance HealthStream courses. Develops a cadence of communication to ensure timely completion.
- Performs general Compliance Group Education for staff utilizing effective training methods and job aides.
- Facilitates new leadership and new staff orientation.
- Participates on committees directed toward promoting compliance and serves as IHA liaison for all non-risk records request questions.
- Works with the Director of Compliance to screen questions for non-risk related items. Forwards all identified risk-related items to Risk Manager for response.
- Manages electronic information database for tracking and analyzing data as required in IHA’s annual Audit Plan and as directed for Compliance matters which arise and require analysis. Utilizes data from trend analysis and identifies opportunities to strengthen internal processes and compliance with IHA standards.
- Assists Director in preparing Compliance Communication to leaders, providers and staff to disseminate important Compliance topics.
- Performs On-Site assessments for all new and transitioning practices to ensure site compliance.
- Monitors the Compliance hotline and Compliance email.
- Assists Director in being a liaison between Trinity Health’s area hospitals and IHA regarding varied accreditation requirements.
- Assists in planning and facilitating quarterly compliance committee meetings.
- Assists Director with projects such as Conflict of Interest, Collaborative Agreements, Across State Lines, Open payments, vendor payments, information blocking, forms and records release.
- Receives compliance concerns and patient rights privacy help desk events, investigates and responds in a timely manner to provide direction and guidance.
- Responsible for reviewing, investigating and processing external, internal, and IHA and Trinity Access Report privacy events.
- With the Privacy Officer, establishes an ongoing process to track, investigate and report inappropriate access and disclosure of protected health information. Monitors patterns of inappropriate access and/or disclosure of protected health information.
- Assists in managing required breach determination and notification processes under HIPAA and applicable State breach rules and requirements. Performs required breach risk assessment, documentation, and mitigation. Assists Director in working with Human Resources to ensure consistent application of sanctions for privacy violations.
- Participates in the development, implementation and ongoing compliance monitoring of all business associates and business associate agreements, to ensure all privacy concerns, requirements and responsibilities are addressed.
- Performs other duties as assigned.
ORGANIZATIONAL EXPECTATIONS:
- Creates a positive, professional, service-oriented work environment by supporting the mission and values of both IHA and Trinity Health.
- Must be able to work effectively as a member of the Compliance team.
- Successfully completes IHA’s “The Customer” training and adheres to IHA’s standard of promptly providing a high level of service and respect to internal or external customers.
- Maintains knowledge of and complies with IHA standards, policies, and procedures.
- Maintains general knowledge of IHA office services and in the use of all relevant office equipment, computer and manual systems.
- Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines.
- Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respect cultural differences.
- Uses resources efficiently.
- Responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials; participates in available learning opportunities.
MEASURED BY:
Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.
ESSENTIAL QUALIFICATIONS:
EDUCATION: Bachelor’s Degree or equivalent combination of relevant education and experience.
CREDENTIALS/LICENSURE: Compliance Certification HCCA preferred/willingness to obtain certification and maintaining continuing CEUs.
MINIMUM EXPERIENCE: 2 years’ experience in the following areas: Compliance, HIPAA, regulatory standards, or experience in IHA operations position.
POSITION REQUIREMENTS (ABILITIES & SKILLS):
- Knowledge of federal, state and insurance company regulations and contract requirements affecting compliance in a healthcare setting; understands managed care and insurance practices.
- Understanding of general coding principals, insurance claims and billing process; HMO, PPO, TPA and commercial insurance types; fee schedules and pricing.
- Well-developed understanding and/or hands-on experience with office processes, procedures and workflows.
- Knowledge of Compliance plan and auditing standards, organization policies and procedures.
- Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, Microsoft Word and Excel, Point, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job including EPM and EHR systems.
- Proficiency in planning, organizing and prioritizing workloads.
- Ability to work effectively with various levels of organizational members and diverse populations including IHA Divisional leadership, staff, providers, patients, family members, outside customers and vendors.
- Effective, professional communication skills, verbal and written, and during group presentations. Ability to speak before groups of people, either in-person or virtually.
- Ability to coordinate activities and work independently to complete projects in a timely manner requiring highly complex analysis.
- Works collaboratively in a team-oriented environment demonstrating a courteous, professional and friendly demeanor.
- High level of organizational and time management skills with ability to effectively juggle multiple priorities and time constraints in a fast-paced environment.
- Exercises sound judgment and problem-solving skills.
- Ability to maintain any organizational information in a confidential manner.
- Successful completion of IHA competency-based program within introductory and training period.
- Ability to work overtime hours as scheduled.
- Ability to drive to other office/practice sites and meeting and training locations.
Location: Central · Compliance
Schedule: Full Time
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