Tufts Medical Center Compliance Specialist in Boston, Massachusetts

Compliance Specialist

Department: Corporate Compliance and Internal Audit

Schedule: Full-Time Regular

Shift: Day shift

Grade: 10

Hours: Monday-Friday 8:00-4:30

Job Details:

  • Bachelor's degree is preferred

  • Bilingual candidates are encouraged to apply

  • Customer service skills are required

  • Recent experience in the specialty area is required

  • The Compliance Specialist assists with the development and maintenance of compliance and privacy program initiatives, including policy and procedure development, training and education communications, monitoring tools and analysis, auditing initiatives and risk management and policy program functions. Responsibilities: Contributes to the achievement of Compliance and Privacy Office objectives while consistently applying corporate values of communication, accountability, respect, and environmental stewardship in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health care system. Effectively serve as a resource for the Compliance and Privacy Office in an effort to increase awareness and participation on a hospital wide basis with the Compliance and Privacy program. Organizes and maintain inventory of organization wide policies and procedures, and help to identify critical associated gaps. Assist departments and staff with creation of sound, mutli-disciplinary communication mechanisms. Develop monitoring tools and data analysis methods to evaluate performance of departments or data in accordance with applicable corporate requirements, and/or law Conduct or assist with audit Compliance and Privacy audits as needed. Develop audit working papers, review documentation provided for audit purposes, drafts written reports of factual observations, findings and recommendation designed to improve compliance. Reviews final, approved reports and recommendations with physician leadership, individual practitioners and affiliate management, as appropriate, providing advice and counsel as needed. Requirements: Level of knowledge generally obtained through completion of a bachelor's of science degree in a health profession, or related area, or equivalent. JD, MBA, or other advanced degree a plus. 2-4 years prior health care experience required; demonstrated interest or participation in health care compliance department preferred. General knowledge of third-party reimbursement policies sufficient to compare details of diagnosis, prescription, treatment and evaluation to documentation necessary for maximal reimbursement for patient care services. General knowledge of CPT and ICD-9, 10 coding techniques and Evaluation and Management guidelines. Knowledge of MS Office (Word, Excel, PowerPoint and Outlook). General knowledge of federal and state regulatory issues relating to health care required. Good communication skills, both verbal and written. Ability to handle and maintain confidential information. Demonstrated planning and problem solving and project management skills.