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Corporate Compliance Specialist

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POST DATE 8/19/2016
END DATE 11/1/2016

Valley Health System Ridgewood, NJ

Ridgewood, NJ
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree


Job Description:

* Position Summary:

* The Compliance Specialist assists the Valley Health System Compliance Manager in the implementation and evaluation of Valley Medical Group s Compliance Program and with the compliance assessments of the Valley Health System s operations to ensure compliance with federal, state, and local regulatory, contractual and legal requirements.

* The Compliance Specialist performs research on industry regulations, policies and contractual requirements, conducts investigations, audits and monitors internal processes and controls, educates management, clinicians and staff and provides guidance to ensure compliance with applicable statutory and regulatory requirements and organizational policies.


* Compliance Manager


* Participates in the development and implementation of the annual compliance work plan based on an internal risk assessment and Federal and State initiatives.

* Coordinates the development of written policies and procedures regarding compliance with local, State and Federal guidelines.

* Serves as a resource to physicians; non-physician providers; support staff; administrators and other personnel concerning the interpretation and implementation of Medicare; Medicaid and other third party payer documentation and billing requirements.

* Conducts investigations; audits and monitors internal processes and controls to ensure compliance with applicable statutory and regulatory requirements.

* Creates a working relationship with clinicians; management and staff to promote the effectiveness of the Compliance Program. Acts as a liaison between the administrative departments and clinical areas to operationalize statutory and regulatory requirements and organizational policies and coordinates the implementation of remedial measures.

* Provides ongoing education and training to support the effectiveness of the Compliance Program.

* Maintains tracking systems for compliance related issues and assists in preparing reports on the status of investigations; findings; and remedial measures.

* Assists Compliance Manager with other activities that support all aspects of the Compliance Program as necessary.

* Performs other duties as assigned/necessary.


* All members of The Valley Health System and external vendors.





* Office, Hospital and Ambulatory Site Environment and Physician Offices. May have exposure to agitated, delirious, confused patients and/ or family members exhibiting aggressive displays of threatening and/ or violent behavior.


* Bachelor s Degree in Business, Finance, Allied Health Professions or other related field from an accredited program required

* Coding certification from AAPC or AHIMA or related certification preferred

* Four (4) years of healthcare compliance auditing work experience with at least two (2) years in physician office setting

* Proficiency with physician documentation and reimbursement methodologies

* Previous experience with personal computers and software applications to include Microsoft Word, Excel and PowerPoint

* Strong written, verbal and presentation skills


* OSHA Bloodborne Pathogen Category III Employees in this job description are NEVER expected to have contact with bloodborne pathogens. Familiarization with the Federal Occupational Safety and Health Administration s Bloodborne Pathogen Standard (CFR 1910.1030) is given during orientation and annually.

Valley is an equal opportunity employer. Valley does not discriminate on the basis of race, creed, religion, color, national origin, age, ancestry, nationality, marital or domestic partnership or civil union status, sex, pregnancy, gender identity or expression, disability, liability for military service, affectional or sexual orientation, atypical cellular or blood trait, genetic information (including refusal to submit to genetic testing) or any other basis made unlawful by federal, state or local law or ordinance or regulation.