This position is responsible for helping establish and execute a risk-based audit and internal monitoring plan which detects and prevents fraud, waste, and abuse (FWA), and misconduct, in order to maintain the highest level of ethics and to comply with all relevant federal and state statutes, regulations and other guidance.
Capable of conducting independent investigations and audits related to Medicare, Medicaid, Commercial and Provider related business segments for compliance.
Department Specific Job Details:
Education
- Associate's degree required, Bachelor's degree preferred.
Experience:
- 5+ years in Healthcare required
- Coding experience preferred
- Experience developing and delivering training to multidisciplinary audiences (highly preferred)
- Excellent presentation, communication, and interpersonal skills
Certifications/ Professional exp
- CHC-Certified Healthcare Compliance, must acquire within first 12 months, preferred.
- CCS-Certified Coding Specialist certification preferred; 1+ year compliance/ regulatory, preferred.
- Understanding regulations (HIPPA, Stark Law, Anti Kickback Statute) preferred
Education Requirements:
Associates (Required)Certification/License Requirements:
[Cert] CCS: Certified Coding Specialist - American Health Information Management Association, [Cert] CHC: Certified Health Care Compliance - Compliance Certification BoardSimilar Jobs
What We Do
Dayton Children's Hospital is the only facility in the region devoted to the health, safety and information needs of children and their families.
Dayton Children's is staffed by pediatricians, pediatric specialists and clinical staff with special training and experience in caring for children. In addition, everything from room decor to life-saving equipment in is designed with the comfort of children in mind.
As a regional referral center, Dayton Children's draws patients from a 20-county area that includes Ohio and eastern Indiana. Dayton Children's affiliation with Wright State University School of Medicine and accreditation by the Joint Commission on Accreditation of Healthcare Organizations ensures young patients the finest pediatric care available.
Dayton Children's staff of over 200 physicians and residents includes primary care pediatricians as well as subspecialists in over 35 areas of pediatric medicine. Working as a team with the medical staff are more than 3500 employees and volunteers who share a commitment to quality care no matter what their specific titles or duties.
