
Healthcare Compliance Coordinator
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Job Description
Description
HEALTHCARE COMPLIANCE COORDINATOR JOB SUMMARY
This position primarily provides administrative support to the CAO and serves as CCHC's Privacy Officer. The individual will work as a liaison between Comprehensive Community Health Centers (CCHC) and its contracted IPAs and health plans, reviews and supports implementation of regulatory guidance or laws, and supports all areas of Compliance.
HEALTHCARE COMPLIANCE COORDINATOR ESSENTIAL DUTIES AND RESPONSIBILITIES
- Provides administrative support to the CAO.
- Develops and maintains positive relationships with IPAs and health plans by conducting over-the-phone and on-site meetings, and leading joint operating committee (JOC) meetings with IPA and health plan representatives on a regular basis.
- Addresses operational issues between CCHC and IPAs and health plans regarding claim submissions, authorization issues, provider contracting issues, credentialing issues, and other issues as directed.
- Maintains IPA and Plan contracts.
- Maintains provider and vendor contracts.
- Maintains all internship, externship, volunteer agreements with educational institutions and programs
- Remains current and up to date on IPA, health plan and other state and federal legislation, including HRSA requirements, impacting CCHC. Includes but is not limited to interpreting guidelines, disseminating information to other CCHC Department Heads and providers, training staff on new requirements, and developing policies and procedures to support new or changing requirements.
- Ensures adherence with federal and state regulations and accreditation standards.
- Responsibilities also include operating, overseeing, and modifying CCHC's Compliance Program, and internal monitoring of CCHC operations for compliance purposes.
- Responsible for working with legal counsel, when directed by CAO.
- Establishes and maintains required language, contract provisions and terms for all agreements entered into by CCHC
- Identify information security, confidentiality and release of patient information/HIPAA issues.
- Serves as CCHC's Privacy Officer
- Provide administrative support to Compliance Department, including preparation for the Board of Directors quarterly Compliance Committee meeting.
- Coordinates with CCHC's Credentialing Department and periodically assists the Revenue Cycle (Billing) Department with auditing and troubleshooting of provider data to ensure proper claims adjudication
- Performs other duties as assigned or requested.
Requirements
HEALTHCARE COMPLIANCE COORDINATOR EDUCATION AND EXPERIENCE
- Health Resources and Services Administration (HRSA) experience desired.
- Bachelor's degree in Business Administration, Health Care Administration or other-related field required.
- 3-5 years-experience in a health care setting preferred.
- General knowledge of state and federal legislation specific to the healthcare field.
- Paralegal or contracting experience is desired but not required.
HEALTHCARE COMPLIANCE COORDINATOR PAY RATE: $33-$36/hr (dependent on experience)
HEALTHCARE COMPLIANCE COORDINATOR BENEFITS:
- Medical, Dental and Vision- 100% paid by Employer
- Life Insurance and Accidental Dismemberment- 100% paid by Employer
- Paid Holidays
- Paid Time Off
- 401K
- 401K Matching
- Flexible Spending Account
- Fringe
- Supplemental Insurance
We are committed to providing equal employment opportunities to all applicants, including those with arrest or conviction records. In accordance with the ULAC Fair Chance Ordinance, we will not inquire about or consider criminal history until after a candidate has received a copy of their background check report. All applicants will be evaluated based on their qualifications and ability to perform the essential functions of the job. For more information, please refer to LA County Fair Chance Hiring.
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