Compliance and Privacy Officer

Description: We are North Idaho's premier provider of integrated medical, dental and behavioral health services. Our amazing care teams deliver world-class healthcare utilizing a patient directed, community-focused approach. Providing high quality, affordable Healthcare from the Heart is our passion. Our mission is to deliver a healthcare experience that provides hope, inspires change, and extends life for our patients and our community.

Top reasons to join our team:

• Our employees are mission - minded
• We are passionate about providing excellent patient care
• Community-focused
• Committed to a fun and supportive team environment
• We offer high-quality competitive employee benefits

. Requirements: The Compliance and Privacy Officer will oversee, coordinate and ensure all the elements of the Corporate Compliance Program have been developed, implemented, and maintained effectively. This position will require knowledge of healthcare administration and specifically healthcare procedures and regulations and knowledge of applicable compliance guidance, laws, and regulations. He/she must be able to exercise initiative, judgment, and problem-solving skills. Must also be able to organize and analyze data and can communicate results clearly. He/she will also coordinate, develop and maintain policies and procedures as needed.

1. Bachelor's Degree in healthcare administration, business management, law or closely related field preferred.
2. Professional experience in a Hospital or Healthcare Revenue Cycle Leadership role including cash management, billing or coding and experience in a management capacity.
3. Compliance certification preferred (CPCO, CHC)

Knowledge, Skills, and Abilities Required:

1. Skilled in the use of personal computers and related software applications.
2. Must be a strategic thinker and insightful decision maker with ability to analyze and solve problems.
3. Records maintenance skills.
4. High level of analytical and organizational skills.
5. Excellent communication skills, both verbal and written.
6. Strong knowledge of healthcare laws and regulations.
7. Knowledge of cash management principles and/or procedures.
8. Skill in organizing resources and establishing priorities.
9. Knowledge of health care billing procedures, documentation, and standards.
10. Ability to supervise and train employees, to include organizing, prioritizing and scheduling work assignments.
11. Ability to foster a cooperative work environment.
12. Ability to make evaluative judgments.
13. Employee development and performance management skills.
14. Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
15. Knowledge of HIPAA and patient confidentiality regulations.
16. Knowledge of cost estimating, budgeting and fiscal management principles and procedures.
17. Knowledge of credit and collection principles, processes, regulations, Federal and Idaho Collection Laws and standards.
18. Knowledge of appropriate billing and payment cycles for medical accounts.
19. Knowledge of staff hiring procedures.

20. Knowledge of operational characteristics and procedural requirements of third party medical insurance payors.
21. Knowledge of procedural requirements and ethical standards for the follow-up of overdue accounts.
22. Ability to develop and maintain recordkeeping systems and procedures.
Duties and Responsibilities:

1. Develops, implements and maintains a corporate compliance program.
2. Conducts investigations as needed for compliance complaints, working closely with our attorneys to ensure proper legal procedure.
3. Evaluates Heritage Health's risks each year by conducting an annual risk assessment and creating an associated work plan to give focus to the Compliance Department for the coming year.
4. Provides formal written quarterly updates to the Board of Directors of the compliance work being completed.
5. Ensures proper record keeping of all compliance complaints received, both actual and perceived.
6. Acts as a resource for the entire company ensuring compliance with all state and federal laws.
7. Creates reference material and provides training to staff as needed.
8. Coordinates with the Billing Department leadership to ensure appropriate billing and coding procedures are completed and being utilized.
9. Coordinates, develops and maintains all Heritage Health policies and procedures.
10. Chairs and preserves the Compliance Committee and all associated minutes and action items to maintain an effective committee.
11. Effectively manages the HRSA site visit, including coordinating all associated pre and post work.
12. Oversees and directs the development, implementation and evaluation of Heritage Health's privacy rule program
13. Identifies the need for, develops, implements, and maintains Heritage Health's privacy policies and procedures for PHI in coordination with the leadership team.
14. Establishes and administers a process for receiving, documenting, tracking, investigating and taking action on all reported violations and complaints concerning Heritage Health's privacy practices and its policies and procedures.
15. Communicates with leadership of any trends/issues identified.
16. Provides day-to-day guidance to subordinates and identifies problem areas and takes appropriate corrective action.
17. Provides leadership in mentoring and developing direct reports and staff in a manner that emphasizes the importance of team, collaboration and best practice.
18. Responsible for interviewing, hiring, developing and promoting department staff.
19. Manages work performance, rewards and disciplinary action, as needed for department staff.

20. Serves as a resource to peers, staff and others, team leader and trainer as required.
21. Provides education, develops step actions, standards of performance and monitors and reinforces.
22. Directs, monitors, assigns, and evaluates workflows and processes in assigned areas. Works with other departments to ensure seamless process flow and offers suggestions when a workflow needs to be corrected or changed.
23. Represents the organization at various community and/or business meetings; promotes existing and new programs and/or policies.
24. Continues to seek self-improvement with ongoing continuing education and makes recommendations for the same for those individuals directly supervised.
25. Performs miscellaneous job-related duties as assigned.
Safety:
Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues.
Physical Demands:
Office staff is required to stand, sit, and be mobile one-third to two-thirds of the time. They are required to use hands or fingers to handle or feel over two-thirds of the time; while reaching with hands and arms occurs one-third of the day. Climbing or balancing, stooping, kneeling or crouching occur less than one-third of the time. Communicating by talking/hearing occurs over two-thirds of the day. Amount of time spent lifting or exerting force is about 50% for up to 10 pounds and less than one-third of the time up to 25 - 40 pounds. Rarely is there a need to lift more than 41 pounds. Must be able to manage efficient keyboard use, hear, see, speak and read. Must have ability to travel between Heritage Health locations.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to solve complex practical problems
• Positive interpersonal, communication & persuasion skills over the phone, computer & in person
• Must be able to simultaneously manage several objectives and assign priorities
• Deal with a wide variety of variables in situations where only limited standardization exists
• Ability to interpret a variety of instructions furnished in written or oral form
• Ability to work effectively under pressure to meet deadlines with a strong organization skill set for easy retrieval of information and to ensure competent closure of issues
• Ability to work overtime as needed, maintain alertness & meet the controlled substance policy.
• Good judgment and sound decision making and conflict management skills to inspire confidence from the customer
• Regular and predictable attendance is an essential function
• Manage complex analysis and use deductive reasoning

Working Conditions:
Work is normally performed in a typical interior/office work environment in an office building. Work may be demanding and chaotic at times. May be exposed to patient population that will present a variety of contagious diseases, physical injuries and emotional states of mind.

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