Job Summary
Performs monitoring and auditing activities to ensure BHS’ compliance with federal and state regulations with a primary focus on riskareas as noted in the OIG annual plan and/or the BHS annual plan. Partners with management, staff and physicians to assist in thedevelopment of department specific compliance policies and procedures and training. Investigates concerns, develops corrective actionplans and ensures overpayments are promptly corrected while actively monitoring the ongoing effectiveness of the compliance process.
Education
Minimum:
Graduate of a Registered Nurse program
Preferred:
Bachelor Degree in Nursing
Registration/Certification/Licensure
Current PA RN license
Experience
Minimum:
Five years progressive work experience in a hospital or healthcare environment relating to federal and state regulations and/orreimbursement operational process.
Preferred:
Previous experience in Medicare billing, managed care/utilization, healthcare compliance and/or internal auditing, and policy andprocedure development.
Other Requirements
Ability to use Microsoft Office to create, update and analyze documents.
Status
Non-Exempt
Physical Requirements:
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