Regulatory & Compliance Specialist seeks to hire AdventHealth Maitland who will embrace our mission to extend the healing ministry of Christ.
Established in 1908, AdventHealth is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.
8am - 5pm /M-F
The Regulatory and Compliance Specialist – Revenue Cycle will provide key support to the Finance and Revenue Cycle Departments, with the primary objective of monitoring and researching healthcare legislation at Federal, State, and local levels. Identifies opportunities for process improvement in support of Finance and Revenue Cycle strategic initiatives as they pertain to regulatory compliance. Works with Revenue Cycle Education to ensure training material is current/updated to properly explain rules and laws. Tracks, audits, and provide assessment to operational departments to ensure compliance with all appropriate laws. Liaise with Adventist Health System's Corporate Compliance officers to ensure alignment. Ensures adherence to the AdventHealthCorporate Compliance Plan and to rules and regulations of all applicable agencies and accrediting bodies. Maintains relationships equally respectful to all and performs assessment and observations in an unbiased and consistent manner.
Knowledgeable in Federal and State statutes and regulations governing the healthcare industry.
Knowledge of Medicare, Medicaid, and other payors' billing rules and policies.
Strong problem-solving, analytical, and reasoning skills and solve complex problems within given deadlines.
Must be organized, versatile, and able to work independently.
Detail oriented and self-directed with excellent follow up skills.
Excellent research and analysis skills.
Ability to set priorities and work on multiple tasks in a fast-paced team-oriented environment.
Proficiency in skillful communication, both written and oral, and the principles of documentation.
Able to prioritize problems and escalate appropriately to leadership.
Advanced computer skills; MS Office Suite including Word, Excel and Access; Windows operating system and Internet
Experience with MS PowerPoint (Preferred)
Prior consulting experience (Preferred)
Bachelor's degree in Business, Healthcare, Health Services, Public Health, or a related field.
Four years of experience in compliance related field
Master's in health services, Public Health, Healthcare Administration, Healthcare Compliance, or related field(Preferred)
Licensure, Certification, or Registration Required:
Demonstrates through behavior AdventHealth's Core Values of Keep Me Safe, Love Me, Make it Easy, and Own it as outlined in the organization's Performance Excellence Program.
Demonstrates, through behavior, Florida Hospital's core values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork.
Monitor and communicate federal and state health care program statutes, regulations, rules and guidance regarding reimbursement, conditions of payments, and other material requirements.
Continuously work to understand changes in payer policies and behavior and communicate changes with appropriate department personnel.
Research compliance and regulatory issues and provide recommendations and/ or corrective action plans to management teams to resolve issues and ensure they do not reoccur. Coordinate with departmental leadership to implement action plans and process improvements, and train staff to mitigate errors.
Leads the Revenue Cycle Compliance Steering Committee. Engages committee members in internal and/or external training programs, and to develop strategies for preparing for upcoming legislative requirements. Serve as the primary source/subject matter expert for interpretation of such legislative billing rules and regulation.
Conduct or assist with compliance audits, ensuring audits are performed in a timely manner and in accordance with established Federal, State, and other regulations, and guidelines.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Regulatory & Compliance Specialist opportunity with AdventHealth Maitland and apply online today.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.