Senior Compliance Specialist

 
Position: Senior Compliance Specialist

Job ID: 149975

Location: US-TX-Houston

Department: COMPLIANCE AND PRIVACY OFFICE

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.  

Summary:

We are searching for a Senior Compliance Specialist to perform physician based audits - someone who works well in a fast-paced setting. In this position, you'll plan and manage audits, reviews, investigations and projects to ensure compliance with the organization’s policies/procedures and state and federal rules, regulations, and statutes.

 

Think you’ve got what it takes?



Responsibilities :

  • Conducts and manages compliance audits, reviews, projects, or investigations
  • Ensures that written reports and correspondence are organized, accurate, appropriate in content, professional in appearance, and appropriately convey the reported issue(s)
  • Assists operational areas with implementing recommended changes to enhance operations or mitigate risk
  • Conducts compliance training
  • Assists in the on-going development/maintenance of the organization’s compliance program per OIG requirements
  • Monitors regulatory environment; evaluates statutes, regulations, and laws to determine applicability to the organization
  • Communicates information to appropriate personnel
  • Engages in risk analysis activities
  • Leads the work of compliance specialists, compliance assistant(s), and others

 



Qualifications:

  • High school diploma or GED
  • 9 years of experience in a health care regulatory environment including specific experience in project management and audit type work such as planning, supervising, executing, and reviewing audits, reviews, or investigations
  • Bachelor’s degree in health care or business-related field can substitute for 4 years of experience
  • Certified Professional Coder, Certified Coding Specialist – Physician-based all preferred
  • Strong in-depth knowledge of CPT, ICD-10 coding methodologies, and billing, as well as an understanding of general business systems and their related control structure, knowledge of current issues affecting the health care industry, and in-depth knowledge of the health care regulatory environment
  • Strong knowledge of hospital medical record charting is preferred
  • Ability to analyze data, people and situations, determine errors and problems, formulate workable and practical solutions, interact with all levels of employees, and able to work in a team environment
  • Strong written and oral communication skills as well as strong project management skills
  • Must have good PC skills including word processing, spreadsheet, graphics and database software applications


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