Compliance Coord - Compliance - Miamisburg - FT / Days

Compliance Coordinator

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Responsibilities & Requirements

The Compliance Coordinator identifies and assesses billing compliance, operational and financial risks across the Kettering Health Network and within the employed physician network, Kettering Physician Network (KPN). The Compliance Coordinator audits and monitors departments and physician practices for compliance with existing policies and governmental regulations. Develops compliance and education plans, policies and procedures that affect operations and assure recommendations to minimize risk are implemented timely and effectively. Monitors new government compliance rules and regulations affecting patient billing in all facilities and physician offices. Reports directly to Network Director of Compliance Operations.

Job Responsibilities

The job duties of the Compliance Coordinator role include, but are not limited to, the following :

• Auditing and monitoring hospital departments and / or employed physician practices for billing and coding compliance in accordance with payer requirements and providing education to internal clients based on audit findings;
• Supporting the development and communication of Kettering Health's compliance and monitoring plan;
• Assisting with drafting healthcare compliance-related policies and procedures;
• Supporting the assignment and investigation of hotline concerns submitted to the compliance department;
• Researching, as needed, various issues related to Stark law, the Anti-Kickback Statute, EMTALA, False Claims Act, provider-based rules, conflicts of interest and beneficiary inducement; and
• Reviewing / auditing physician payments for contractual compliance.

Job Requirements