Tennessee Oncology

Community-based cancer care with clinical research

Compliance Specialist

Regulatory Compliance & EthicsConfirmed live in the last 24 hours

Full-timeNashville, TN, USANo salary listedIn-person

About the Job

Requirements

A minimum of an associate degree in a healthcare-related field is required; a bachelor's degree is preferred.
At least 5 years of healthcare compliance and/or privacy experience.
Compliance and/or privacy certifications are desired but not required.
Knowledge of healthcare organization operations, quality assurance, HIPAA, revenue cycle management, coding and billing, safety, and federal and state healthcare regulations.
Knowledge of current laws, regulations, administrative guidance, and industry practices affecting compliance obligations, including Stark, Anti-kickback, HIPAA, Medicaid/Medicare regulations, and CMS Fraud, Waste, and Abuse guidelines.
Ability to work independently and demonstrate investigative skills, effective communication, integrity, and confidentiality.
Ability to assume responsibility and exercise good judgment within the position's scope of authority.
Knowledge of and ability to use conflict resolution and problem-solving techniques.
Proficiency in Microsoft Word, Excel, Visio, and PowerPoint.
Ability to prioritize tasks and meet deadlines.
Must maintain a valid driver's license.

Responsibilities

Assist the Chief Compliance & Privacy Officer with day-to-day department operations.
Assist in preparing audit work papers and reports for compliance audit activities, including audits of coding, billing, provider documentation, and reimbursement processes.
Compose reports that accurately outline audit findings.
Assist with annual compliance risk assessments, work plans, and action plans to mitigate findings.
Assist in investigations of compliance and privacy concerns.
Ensure complete, accurate, and timely closure documentation for complaints from patients, staff, and internal or external providers, including hotline complaints.
Create and maintain compliance and privacy event logs.
Establish a structured process for tracking new and upcoming regulatory changes and collaborate with other departments to develop and initiate employee education plans for relevant regulatory program requirements.
Assist in developing and providing compliance and privacy training for providers, employees, and other workforce members, and track completion of new-hire and annual training assignments.
Assist with creating and reviewing compliance policies and procedures, and participate in periodic reviews and revisions of the Notice of Privacy Practices, Code of Conduct, and other regulatory documents.
Review and resolve the OIG Exclusion List monthly.
Conduct compliance and privacy walk-throughs at all Tennessee Oncology locations.
Maintain a strong working knowledge of local, state, and federal rules and regulations.
Research and answer staff questions regarding compliance and privacy regulations.
Perform user activity audits as assigned.
Perform duties in accordance with Tennessee Oncology's mission, values, and policies and procedures.
Perform other duties as assigned.

Desired Qualifications

A bachelor's degree in a healthcare-related field is preferred.
Compliance and/or privacy certification(s) are desired but not required.

Tennessee Oncology, one of the nation’s largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the country. Established 1976 in Nashville, Tennessee Oncology’s mission remains unchanged: To provide access to high-quality cancer care and the expertise of clinical research for all patients, at convenient locations within their community and close to their home. Our growing network of physicians and locations is based on this mission. Tennessee Oncology is committed to advancing both the science of detection and targeted treatments, and to making these advances available to every patient. We believe caring for cancer patients is a privilege.

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description:

The compliance specialist provides compliance and privacy support to the organization. Their duties may include conducting audits, monitoring actions plans, investigating matters as assigned, providing education and training, and participating in projects to help ensure that Tennessee Oncology is compliant with local, state, and federal laws, rules, and regulations.

ESSENTIAL FUNCTIONS:

Will assist Chief Compliance & Privacy Officer with day-to-day operations of the department.
Assist with preparing audit work papers and reports to effectively conduct, document, and communicate all compliance audit activities. Audits will include coding, billing, provider documentation, and reimbursement processes and others as assigned.
Compose reports which accurately outline any findings as a result of the audit work.
Assist with conducting annual compliance risk assessments, work plans and action plans that mitigate findings.
Assist in investigations of compliance and privacy concerns.
Assist with complete, accurate and timely closure documentation of complaints from patients, staff, and internal or external providers, including hotline complaints.
Create and maintain compliance and privacy event logs.
Establishes a structured process for tracking new and upcoming regulatory changes and collaborate with other departments to develop and initiate plans to educate Tennessee Oncology employees on relevant regulatory program requirements.
Assist in the development and provision of compliance and privacy training for providers, employees, and other workforce members. Will track completion rates of all employees, both for New Hire and Annual Training Assignments.
Assist with creating and reviewing compliance policies and procedures. Participate in periodic reviews and revisions of the Notice of Privacy Practices, Code of Conduct and other regulatory documents as needed.
Responsible for reviewing and resolving the OIG Exclusion List on a monthly basis.
Responsible for compliance and privacy walk-throughs in all Tennessee Oncology locations.
Maintain a strong working knowledge of local, state, and federal rules and regulations.
Researches and answer questions from staff regarding compliance and privacy regulations.
Perform USER activity audits as assigned.
Perform duties in accordance with Tennessee Oncology mission, values and policies and procedures.
Perform other duties as assigned.

KNOWLEDGE, SKILLS & ABILITIES:

Ability to work independently, excellent investigative skills, the ability to communicate effectively and a high level of integrity and confidentiality.
Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
Knowledge of and ability to utilize conflict resolution and problem-solving techniques.
Must be proficient in the use of Microsoft Word, Excel, Visio, and PowerPoint.
Ability to prioritize tasks and meet deadlines.
Must maintain a valid driver’s license.

EDUCATION & EXPERIENCE:

A minimum of an associate degree, bachelor preferred, in a healthcare related field and at least 5+ years healthcare compliance and / or privacy experience.
Compliance and / or privacy certification(s) desired but not required.
Healthcare organization knowledge of operations, quality assurance, HIPAA, revenue cycle management, coding and billing, safety, federal and state healthcare regulations.

Knowledge of current laws, regulations, administrative guidance and industry practices that affect compliance obligations including Stark, Anti-kickback, HIPAA, Medicaid/Medicare regulations, and CMS Fraud, Waste, and Abuse guidelines.

PHYSICAL REQUIREMENTS:

Job Title: Compliance Specialist

Physical Activity Required

Amount of time

None

Less than 1/3
(Occasionally)

1/3 to 2/3
(Frequently)

More than 2/3
(Regularly)

Standing

Walking

Sitting

Fingering or manual dexterity

Repetitive finger motion

Lifting or exerting force

Up to 10 pounds

Up to 25 pounds

Up to 50 pounds

Up to 100 pounds

Over 100 pounds

Reaching or stretching

Climbing or balancing

Crouching or stooping

Speaking

Hearing

Seeing (with correction)

About the Company

Tennessee Oncology

Community-based cancer care with clinical research

Tennessee Oncology runs a large network of community-based cancer care with a strong clinical-trial program. It delivers cancer treatment at local clinics, including on-site chemotherapy, and uses molecular diagnostics to tailor therapies to each patient’s cancer. The organization supports patients with its in-house Park Pharmacy, which stocks oncology and hematology medications and handles insurance, prior authorizations, co-pays, and 24/7 pharmacist access. It differentiates itself by combining extensive community-based care with a sizable research network and a partnership with OneOncology, enabling broad access to trials and advanced care at convenient locations. The goal is to provide high-quality cancer care and access to clinical research close to patients’ homes.

Company size: 501-1,000
Company stage: Debt Financing
Total funding: $98.3M
Headquarters: Nashville, TN
Founded: 1976

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