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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare compliance, including conducting audits, training staff, and managing compliance-related projects. Proficient in EMR optimization and regulatory adherence, with strong analytical and decision-making skills.
Highest-signal resume keywords
Healthcare Compliance ExperienceProject Management ExperienceEMR OptimizationAudit and Investigation SkillsTraining and Mentoring Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare ComplianceAudit ManagementRisk AssessmentProject ManagementData Analysis
Soft Skills
Analytical SkillsAttention to DetailCritical ThinkingDecision-MakingCollaboration
Tools & Technologies
EMR SystemsCompliance Software
Certifications & Qualifications
RHITRHIACCSCCS-P
Industry Keywords
Corporate ComplianceRegulatory AuditsRevenue CycleHealthcare AdministrationFraud Investigation
About the role
Key responsibilities & impact- Mentor and train less experienced staff
- Support resolution of complex issues and technical questions
- Conduct Corporate Compliance audits, investigations, and training across affiliates
- Guide system administration and RGHS management on compliance with laws, regulations, and contract obligations
- Serve as subject matter expert for building and optimizing the EMR
- Manage projects independently and prepare governmental disclosures
- Facilitate external audits by regulatory agencies
- Coordinate audits covering revenue cycle, financial statements, payments, attestations, grants, employees, contractors, exclusions, and payment agreements
- Interview staff to identify root causes of issues
- Collaborate with healthcare professionals to discuss findings and provide compliance education
- Develop audit reports and present findings to Compliance Director, RGHS Administration, and management
- Develop and assist with implementation of corrective action plans
- Perform follow-up audits to verify monitoring effectiveness
- Analyze government and professional association studies for risk and opportunity
- Identify compliance benchmarks and perform risk assessments
- Monitor regulatory changes affecting departments
- Support new business growth initiatives
- Approve and collaborate on margin improvement initiatives while ensuring compliance
- Provide EMR documentation and workflow training to clinicians
- Design and implement revenue-cycle compliance training for physicians, healthcare providers, HIM coders, and employees
- Manage internal investigations involving fraud, waste, and abuse
- Facilitate corrective action and monitoring in affected departments
- Manage external investigations by OIG, DOJ, OMIG, FBI, Medicare, and third-party payer fraud units
Requirements
What you’ll need- AAS or BS in Health Information Management, Health Care Administration, Finance, or Accounting, and experience with healthcare compliance
- Minimum five years of healthcare experience, including a minimum of 3 years of health care compliance experience
- A combination of healthcare work experience, credentials and/or education will be considered
- RHIT, RHIA, CCS, or CCS-P
- Relevant health care related certification with experience may be considered in lieu of above certifications
- Strong analytical skills
- Project management experience
- Training skills
- High degree of mental and visual acuity, attention to detail, critical thinking, and decision-making
- Sedentary work requirements, including prolonged sitting and computer, writing, and telephone use
- May require flexible hours, TB screening, or a valid driver’s license