UF Health
Overview
Position Summary: Regulatory Compliance Specialist
The role is responsible for providing
ongoing compliance monitoring and auditing
for a
multi-hospital healthcare system . Key functions include the review and analysis of: Regulatory requirements, including but not limited to documentation and medical necessity Compliance with applicable laws, rules, guidelines and regulations Auditing, monitoring and special projects General compliance training and education Enterprise compliance policies and written standards of conduct General compliance processes, including inquiries, investigations and responding to reported, suspected, or confirmed non-compliance These activities ensure both
appropriate reimbursement
for the hospital and
adherence to all applicable laws, rules, guidelines, and regulations .
Responsibilities
Key Responsibilities
Conduct
ongoing compliance monitoring and auditing
across UF Health. Perform
analyses
to support regulatory compliance. Fosters open lines of
communication
and
communicates
key compliance topics to staff and UF Health leadership. Deliver
compliance education and training
to staff. Research and respond
to compliance-related inquiries. Follow established
investigation protocols
to address reported, suspected, or confirmed non-compliance. Participate in and contribute to
compliance meetings , encouraging open communication throughout the organization. Assist in developing and monitoring
special compliance projects in collaboration with Compliance Managers and various hospital departments. Provide
compliance advice and guidance
to staff and leadership, as needed. Qualifications
Education
Bachelor's Degree in a health, education, or business-related field with 2 years' work experience in clinical, coding, auditing, legal, clinical research or related field, OR Associate's degree with 4 years' work experience in above stated fields, OR Associate's degree with certifications in Compliance, coding and/or auditing AND 6 years' work experience in above stated fields, OR Advanced Degree (e.g. Juris Doctorate) with knowledge of and experience with healthcare statues and regulations that govern hospitals and/or the health care industry Licensure/Certification/Registration
RN, LPN, RHIA or RHIT, CPC-H/COC, CPC, CCS, CHC/CHRC preferred Must obtain Certification in Healthcare Compliance (CHC) or Certification in Healthcare Research Compliance (CHRC), as applicable, within 18 months of hire or transfer into the department Additional certifications may be required to support or enhance departmental expertise (e.g. Certified Professional Coder (CPC) or Certified Outpatient Coder (COC)) Special Skills/Qualifications/Additional Training/Experience Required
Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred Must be knowledgeable of state and federal statutes and regulations governing the healthcare industry Ability to research and understand complex regulations is required Proven ability to solve problems is essential Intermediate skills with MS Office tools (including Excel, Word, and Power Point) is required Must be organized, versatile, and able to work independently Must be able to read, write, speak and understand English
Position Summary: Regulatory Compliance Specialist
The role is responsible for providing
ongoing compliance monitoring and auditing
for a
multi-hospital healthcare system . Key functions include the review and analysis of: Regulatory requirements, including but not limited to documentation and medical necessity Compliance with applicable laws, rules, guidelines and regulations Auditing, monitoring and special projects General compliance training and education Enterprise compliance policies and written standards of conduct General compliance processes, including inquiries, investigations and responding to reported, suspected, or confirmed non-compliance These activities ensure both
appropriate reimbursement
for the hospital and
adherence to all applicable laws, rules, guidelines, and regulations .
Responsibilities
Key Responsibilities
Conduct
ongoing compliance monitoring and auditing
across UF Health. Perform
analyses
to support regulatory compliance. Fosters open lines of
communication
and
communicates
key compliance topics to staff and UF Health leadership. Deliver
compliance education and training
to staff. Research and respond
to compliance-related inquiries. Follow established
investigation protocols
to address reported, suspected, or confirmed non-compliance. Participate in and contribute to
compliance meetings , encouraging open communication throughout the organization. Assist in developing and monitoring
special compliance projects in collaboration with Compliance Managers and various hospital departments. Provide
compliance advice and guidance
to staff and leadership, as needed. Qualifications
Education
Bachelor's Degree in a health, education, or business-related field with 2 years' work experience in clinical, coding, auditing, legal, clinical research or related field, OR Associate's degree with 4 years' work experience in above stated fields, OR Associate's degree with certifications in Compliance, coding and/or auditing AND 6 years' work experience in above stated fields, OR Advanced Degree (e.g. Juris Doctorate) with knowledge of and experience with healthcare statues and regulations that govern hospitals and/or the health care industry Licensure/Certification/Registration
RN, LPN, RHIA or RHIT, CPC-H/COC, CPC, CCS, CHC/CHRC preferred Must obtain Certification in Healthcare Compliance (CHC) or Certification in Healthcare Research Compliance (CHRC), as applicable, within 18 months of hire or transfer into the department Additional certifications may be required to support or enhance departmental expertise (e.g. Certified Professional Coder (CPC) or Certified Outpatient Coder (COC)) Special Skills/Qualifications/Additional Training/Experience Required
Familiarity with hospital billing systems and medical records, strong coding skills, and clinical background preferred Must be knowledgeable of state and federal statutes and regulations governing the healthcare industry Ability to research and understand complex regulations is required Proven ability to solve problems is essential Intermediate skills with MS Office tools (including Excel, Word, and Power Point) is required Must be organized, versatile, and able to work independently Must be able to read, write, speak and understand English