Responsible for all activities related to order compliance and management of physician data in system(s); this position assures optimal regulatory compliance.
Essential Functions:
Monitor orders which are in Mosia escalation folder and perform necessary follow-up.
Provide education and support to Medical Records staff as it pertains to Mosia and indexing, to ensure timely and appropriate follow-up.
Monitor reports and Mosia tracking features to assure goals of Orders Lifecycle are met.
Perform follow up related to timely receipt of unsigned Orders including calls to physician offices and communication with Clinical team members/managers to resolve issues as needed.
Elevate unresolved issues to Team Leader or Manager.
Document actions in system to support compliance with internal policies and regulatory guidelines.
Verify credentials including licensing, NPI, PECOS, OPRA, and OMIG/OIG/GSA sanctions, for new providers and update system accordingly.
Monitor and maintain Add/Change Physician workflow including provider additions and changes, updating provider demographics, delivery methods, as well as changes in corresponding orders as needed.
Develop working relationships with Physicians offices.
Communicate regularly with manager to ensure maximum compliance with orders.
Process face-to-face encounters.
Transmit OASIS assessments as needed.
Perform compliance related investigations.
Other duties as assigned.
Qualifications and Requirements:- In lieu of degree, at least 2 years of experience in healthcare compliance or medical records.
- Knowledgeable in medical order compliance.
- Demonstrated ability to apply critical thinking related to order compliance.
- The Compliance Specialist is primarily in an office setting and may be exposed to outdoor conditions.
- The working conditions are classified as sedentary work:
- Sedentary work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
Physical Requirements:
The following is a description of the physical requirements on a daily basis for the Compliance Specialist. While performing the duties of the job the employee is regularly expected to: StandSitHearWalkTalkStoop or kneel Repetitive motion This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed as assigned. EOE/AA Minority / Female / Disability / Veteran
