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Children's National Health System
Silver Spring, MD, United States
Under general supervision from a Compliance Director, the Compliance Specialist monitors CNHS's adherence to regulatory requirements and organizational policies and procedures. This position will interact with all levels of CNHS stakeholders, including staff, management, leadership, and Boards of Directors. Functional accountabilities include inter
Job Source: Children's National Health SystemKittitas
Washington, DC, United States
Responsible for monitoring participant compliance with all policies, procedures, and requirements set out in the Behavioral Health Court program. Must maintain courteous and cooperative working relationships with administrative and other County personnel, public agencies, and the general public, and work under the guidance of Local/State/Federal re
Job Source: KittitasEA Engineering, Science, and Technology, Inc.
, MD, United States
We have an exciting full-time opportunity for an Environmental Health, Safety, and Sustainability (EHSS) Compliance Specialist to support our rapidly growing Environmental, Health, Safety and Sustainability (EHSS) consulting practice in Hunt Valley, MD. What you will do: As a Compliance Specialist, you will collaborate with an experienced team to
Job Source: EA Engineering, Science, and Technology, Inc.Lewis Contractors
Owings Mills, MD, United States
Are you a detail-oriented professional with a passion for ensuring compliance with construction regulations and industry standards? Do you thrive on navigating the complexities of legal requirements and guiding teams towards regulatory excellence? If you're seeking a rewarding role that allows you to be at the forefront of construction compliance,
Job Source: Lewis ContractorsChildren's National Medical Center
Silver Spring, MD, United States
Job Description - Compliance Specialist (240001RB) Job Description Compliance Specialist - ( 240001RB ) Description Description Under general supervision from a Compliance Director, the Compliance Specialist monitors CNHS's adherence to regulatory requirements and organizational policies and procedures. This position will interact with all le
Job Source: Children's National Medical Centeralphanumeric
, MD, United States
POSITION OVERVIEW: Under supervision of the Senior Director of Quality Improvement, the Compliance Specialist is responsible for navigating complex transitional housing regulations to developed and implement related compliance actions and strategies. This position will ensure that Acacia Network Housing remains up-to-date on all regulatory and lice
Job Source: alphanumericChevo Consulting
Hyattsville, MD, United States
CHEVO is hiring a 508 Compliance Specialist to join our team. The 508 Compliance Specialist will provide support to an Agile Software Development Team. RESPONSIBILITIES INCLUDE: Support Agile scrum team in analysis of 508 requirements to identify acceptance test criteria Analyze application design, interface, and database design documentation to i
Job Source: Chevo ConsultingTTI of USA, Inc.
Owings Mills, MD, United States
Primary purpose will be to enter employee data into regulatory system and monitors data accuracy to ensure completeness and compliance. The position is responsible for entering employee trading data into the firm compliance database. This includes receiving and opening the mail, reviewing the contents for the necessary data points that require ent
Job Source: TTI of USA, Inc.Columbia, MD, United States
Maxim Healthcare Services Compliance Specialist Columbia , Maryland Apply Now The primary responsibility of the Compliance Specialist is to review clinical medical records and claims for accuracy of services related to home health care. The Compliance Specialist maintains a comprehensive understanding of ethical principles and independence in their work, professional conduct, duty, and responsibilities. The Compliance Specialist is obligated to articulate principles, have a working knowledge of the rules and regulations as they pertain to all aspects of home healthcare, and observe/ensure the highest level of professional standards, quality care, and legal aspects.
Essential Duties and Responsibilities:
Reviews clinical medical records and claims for accuracy of services related to clinical standards of practice and care, levels of care, quality indicators, medical necessity, length(s) of stay, billing, and denials
Makes proposals related to compliance and continuous quality improvement
Conducts exit conferences and provides timely written feedback
Works collaboratively with Regional Operations and Site Managers
Participates in provider educational programs
Serves as a resource, providing information generated from a sound basis
Ensures confidentiality of medical information related to HIPAA regulations
Displays dedication to corporate objectives
Performs audits as scheduled by the Compliance Leadership team
Completes work product in an accurate and timely fashion as required by the Compliance Leadership team
Ensures business travel is consistent with the business objectives of the Compliance Department, and submits all expense reimbursement requests within 30 days of site visit
Assists with clinical review for claims testing activities
Assists with clinical review for issues investigation and resolution
Performs other duties as assigned/necessary
Active RN license required
BSN or other commensurate healthcare degree preferred
Experience in utilization review, risk management, quality management, documentation specialization, nurse management, compliance, billing, coding, or CFE, LNC, or CPUR certification preferred
At least five years of clinical experience required, preferably in Home Health
Demonstrated knowledge of clinical compliance, medical record review and legal aspects of documentation preferred
Demonstrated knowledge of CPT, ICD 10 codes, DRGs, and APC coding preferred
Understanding of payer rules and regulations, including Medicare and Medicaid preferred
Computer proficiency, including programs such as MS Office, Word, Excel, email, and internet research, required
Travel 50% - 75% of the work time may be required
Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills preferred
Proficiency in the English language is required
About Maxim Healthcare Services
Maxim Healthcare Services has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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Email Alert for Compliance Specialist jobs in Columbia, MD, United States
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