Pathology Compliance Spec-

Pathology Compliance Specialist – Full Time, Day

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The Pathology Compliance Specialist is responsible for planning, coordinating and implementing all aspects of the processes specific to the area. This is accomplished in conjunction with Pathology section heads, the medical and administrative leadership of the department.

• Develops and implements appropriate employee and client office training and education programs in collaboration with the Medical Center’s Vice President, Chief Compliance Officer, to ensure that same are aware of their compliance and HIPAA responsibilities and to encourage high standards of compliance performance throughout the Laboratory.
• Conduct and follow ups investigations and facilitates corrective action as needed in consultation with the Administrative Director and Vice President, Chief Compliance Officer with regard to laboratory compliance issues communicated through the compliance hotline. This may include the development and maintenance of appropriate, confidential records and reports.
• Provides advice and support to laboratory management and staff in efforts to continually improve systems to reduce and eliminate exposure to fraud, abuse and negligence actions related to compliance.
• Develops and maintains appropriate reports to provide information needed by laboratory management and the Vice President, Chief Compliance Officer to continually assess the effectiveness of the laboratory compliance program.
• Develops and maintains a written laboratory compliance plan to include a written laboratory specific manual, consistent with applicable law and regulation, corporate code of conduct, and other related policy and administrative guidance.
• Coordinates a comprehensive evaluation of the effectiveness of the laboratory compliance program periodically and modifies the compliance plan and manual as appropriate.
• Develops and implements consistent, laboratory wide communication that reinforces the goals of the Compliance program in a positive way and maintains momentum to strive for excellence in compliance performance.
• Investigates and resolves potential issues with the Cerner Millennium system (LIS) and any relevant laboratory information systems that might cause discrepancies as it relates to the hospital financial system. Provides compliance guidance for issues related to laboratory pre-analytic, analytic and post-analytic testing and legal medical record documentation.
• Investigates and resolves discrepancies of audits submitted by the Medical Audit department, and monitors trends in discrepancies of testing vs. billing, and follows up accordingly.
• Monitors, investigates and resolves insurance denials originating from lab billing and acts as the liaison between the lab and Patient Accounts for resolution.
• Under the direction of the Administrative Director and the Vice President, Chief Compliance Officer, acts as liaison to outside government and regulatory representatives in compliance related activities.
• Attends compliance coordinating team meetings, Collaborates with appropriate team members to evaluate, develop, implement and oversee effective compliance measurement systems and results reporting.
• Develops an effective compliance program for the outreach specific aspects of the laboratory.
• Acts as liaison to the pathologists for compliance related activities. Attends meeting of the Pathology administrative group.
• Acts as the laboratory liaison to the the Vice President, Chief Compliance Officer.
• Analyzes policies and research regulations for laboratory policies and processes related to research activities.
• Assist with implementation of research study procedures. Ensuring all…