RN Compliance Specialist

Home Care Providers of Texas is seeking a Compliance Specialist (RN)

POSITION SUMMARY:

We are looking for a Compliance Specialist to ensure our company adheres to legal standards and in-house policies. You will be responsible for enforcing regulations in all aspects and levels of business as well as providing guidance on compliance matters. A great Compliance Specialist is well-versed in-home health, hospice, and non-skilled regulatory guidelines and corporate governance best practices. They are professionals of high ethical standards and work diligently to complete their duties keeping in mind the objectives of the business. You must be comfortable saying "no" when necessary and be result-oriented.

A great Compliance Specialist is well-versed in-home health, hospice, and non-skilled regulatory guidelines and corporate governance best practices. They are professionals of high ethical standards and work diligently to complete their duties keeping in mind the objectives of the business. You must be comfortable saying "no" when necessary and be result-oriented.

DUTIES AND RESPONSIBILITIES :

• Develop and oversee control systems to prevent or deal with violations of legal guidelines and internal policies
• Assist in evaluating the efficiency of controls and improve them continuously
• Assist in revising procedures, reports etc. periodically to identify hidden risks or non-conformity issues
• Help draft, modify and implement company policies
• Collaborate with Corporate Compliance Officer and/or Director of Compliance and HR departments to monitor enforcement of standards and regulations
• Assist in assessing the business's future ventures to identify possible compliance risks
• Review the work of colleagues when necessary to identify compliance issues and provide advice or training
• Keep abreast of regulatory developments within or outside of the company as well as evolving best practices in compliance control
• Prepare reports for senior management and external regulatory bodies as appropriate
• Assist in reported claims and investigations
• Excellent knowledge of home health and hospice regulatory guidelines
• In-depth knowledge of the industry's billing standards and regulations
• Experience in processing Additional Document Requests (ADRs), Recovery Audit Programs (RACs), and appeals
• Responsible for collecting, tracking, and reporting compliance data in accordance to State, Federal, and Company policy, including ADRs or audit results and appeals
• Knowledge of various fraud, waste, and abuse detection, deterrence and prevention activities for Medicare
• Excellent knowledge of reporting procedures and record keeping
• Proficient in Word, Excel, and various Office Products
• Methodical and diligent with outstanding planning abilities
• Ability to manage simultaneous projects
• An analytical mind able to "see" the complexities of procedures and regulations
• Excellent communication skills
• The job will also require you to shift priorities as needed throughout the department. You will be cross trained to accommodate other team members when they are out or working on high priority projects
  
  
  

MINIMUM JOB REQUIREMENTS:

Age: Must be a minimum of 21 years of age

EDUCATION/LICENSURE/EXPERIENCE:

• A graduate of an approved school of professional nursing, physical therapy, or occupational therapy and licensed in the state where practicing
• Minimum of two (2) years' experience as registered professional (LPN, RN, PT, OT) with at least one (1) year in home care setting or BA in Healthcare
• Compliance experience is preferred but not required