UF Health · 9 hours ago
Compliance Specialist Sr. | Full time | Day Shift
Gainesville, FL
Full-time
Onsite
Mid, Senior Level
3+ years expUF Health is seeking a Compliance Specialist Sr. to perform complex regulatory and compliance analyses to ensure appropriate hospital reimbursement and adherence to applicable laws. The role involves conducting audits, providing compliance education, and delivering guidance to support organizational adherence to regulatory requirements.
Health CareMedical
Responsibilities
Performs complex regulatory, audit, billing, coding, documentation, medical necessity, and general compliance analyses to ensure appropriate hospital reimbursement and adherence to applicable laws, rules, guidelines, and regulations
Provides support and assistance in refining compliance methodologies and improving departmental work products
Delivers ongoing compliance education and training to support organizational adherence to regulatory requirements
Researches and responds to complex compliance inquiries
Ensures the accuracy and timely completion of complex compliance audits, investigations, reviews, and the Annual Compliance Work Plan
Demonstrates extensive experience and expertise in:
Billing and medical auditing
Medical necessity
Proper documentation and coding
Inpatient and outpatient services
Governmental payer regulations and requirements
Utilizes strong skills in report writing, findings analysis, and the ability to enter, manipulate, and analyze data within database applications and compliance systems
Maintains familiarity with a wide range of compliance concepts, practices, and procedures
Applies independent judgment and professional experience to plan and accomplish assigned goals
Performs a variety of compliance-related tasks as assigned
Provides compliance advice and guidance to stakeholders across the organization
Exercises a high degree of creativity, initiative, and professional latitude in the performance of duties
Qualification
Required
Bachelor's degree required
Minimum of three (3) years of experience in compliance, clinical, coding, auditing, legal, or related work
CHC (Certified in Healthcare Compliance) credential required
Familiarity with hospital billing systems and medical records, with demonstrated coding and billing experience
Knowledge of Medicare, Medicaid, and applicable state and federal laws and regulations governing the healthcare industry
Proven problem-solving ability
Must be organized, versatile, and able to work independently
CHC certification required, or ability to obtain within nine (9) months of hire
Preferred
RN, LPN, RHIA, RHIT, CPMA, or CCS credentials preferred
Company
UF Health
University of Florida Health is a world-class academic health center in Florida, encompassing hospitals, physician practices, colleges, centers, institutes, programs and services across northeast and north-central Florida.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Robert Thornton
Senior Vice President and Chief Financial Officer
Lydia Hendrix BSN,CRRN,MS
Chief Operating Officer
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