Regulatory Compliance Consultant

Introduction

Do you have the career opportunities as a Regulatory Compliance Consultant you want with your current employer? We have an exciting opportunity for you to join HCA Healthcare which is part of the nation's leading provider of healthcare services, HCA Healthcare.

Benefits

HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Our teams are a committed, caring group of colleagues. Do you want to work as a Regulatory Compliance Consultant where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!

Job Summary

We are seeking a Regulatory Compliance Consultant for a role that is key to regulatory compliance for the company. In this role, you will support facilities in implementing and maintaining compliant operations through the development of educational tools and resources. You will also monitor regulatory requirements and assist with compliance questions and issues. This position offers the opportunity to gain experience in billing, charging, coding, and clinical coverage, providing a clear career path within the company.

Major Responsibility:

• Review and research regulatory requirements related to charging, coding, coverage, and billing.
• Support internal and external reviews and monitor for potential compliance risks.
• Perform reviews of claims data and clinical records to ensure compliance.
• Identify and communicate changes necessary for integrating regulatory requirements into operations and systems.
• Identify, investigate, and resolve potential compliance issues.
• Review and research new charging, coding, coverage, and billing regulatory requirements to anticipate changes to current standards and the development of future standards, tools, system enhancements, and educational activities.
• Review and provide research to support internal or external reviews, examine facility-completed action plan response documents, and monitor for potential compliance risks. - Perform reviews of claims data and/or clinical records to ensure compliance in accordance with rules and regulations.
• Provide assistance with issues related to regulatory edits.
• Identify and communicate changes necessary for integrating regulatory requirements into operations and systems.
• Understand standard charging processes, including the chargemaster.
• Identify, investigate, and/or resolve potential compliance issues.
• Review results to identify additional follow-up, education, and support needs, and follow up with facilities to ensure that appropriate corrective action is taken in response to findings.
• Assist with special projects.
• Participate in regulatory project initiatives via interdepartmental/multidisciplinary teams or committees in support of departmental objectives.
• Maintain knowledge of regulatory requirements to ensure compliance and timely education and training.
• Communicate routinely to supervisor any significant issues, the status of projects, barriers, and successes.
• Apply knowledge of medical terminology, payment policies, and subject matter-related expertise.

Education & Experience:

• Minimum of five (5) years’ experience in a healthcare setting for coding, revenue cycle, clinical coverage, or other related healthcare experience required.
• Less than one (1) year of experience in a leadership role preferred.
• Bachelor's degree preferred.
• Equivalent combination of education and/or experience will be considered.

Licenses, Certifications & Training:

• Registered Health Information Technician/Administrator, Certified Coding Specialist (CCS), HCCA, clinical (RN, LPN, PT, or other clinical expertise) or other similar credentials preferred.
• Certified Compliance & Ethics Professional (CCEP) or similar certification preferred.

We are comprised of affiliated hospitals, physician practices and other sites of care across the United States and United Kingdom. The Sarah Cannon Cancer Network is transforming cancer care through integrated services and cutting-edge technologies. Our physicians can develop leading oncology programs to advance science and patient care. Providing physician-led patient care offers our doctors access to a national network of experts. This is where multidisciplinary teams come together with a goal of delivering seamlessly coordinated, quality cancer care. Through a united network of globally recognized oncology specialists, we collaborate and share best practices. We address each aspect of the cancer journey, from screening and diagnosis through treatment and survivorship, to advance our shared mission: Above all else, we are committed to the care and improvement of human life.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Regulatory Compliance Consultant opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.