Healthcare Compliance Manager
New
D
Dozee Health AIHealthcare compliance
Workplace type: Remote; Listing location: TexasFull-TimeManager
Salary not disclosed
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Job Details
- Experience
- Minimum 5 years in healthcare compliance
- Required Skills
- HIPAA
Requirements
- Have a minimum of 5 years of experience in healthcare compliance.
- Hold Certified in Healthcare Compliance (CHC) certification or obtain it within 12 months of hire.
- Have a bachelor's degree; healthcare administration, law, or a clinical field is preferred.
- Have working knowledge of CPT coding, including codes 99453–99470.
- Have working knowledge of CMS PFS Final Rules, the OIG Work Plan, MAC audit processes, and AKS/Stark safe harbors.
- Be proficient in Microsoft 365.
- Have strong SOP writing and audit documentation skills.
- Be able to deliver training to clinical and non-clinical staff.
- Have experience in Medicare billing, HIPAA, or a post-acute/RPM environment; this experience is strongly preferred.
- CHPC privacy certification is a plus.
- Familiarity with healthcare compliance platforms is preferred.
Responsibilities
- Own monthly billing compliance reviews, validate CPT code selection and data-day thresholds, and maintain pre-bill attestation and time-counting controls.
- Monitor CMS Final Rules, MAC Local Coverage Determinations, and OIG Work Plan items affecting RPM billing, and brief leadership on material changes.
- Serve as the designated HIPAA Compliance Officer, conduct annual Security Risk Assessments, manage privacy notices and vendor and partner BAAs, and lead breach workflows.
- Maintain the CAIT/Dozee SOP library, initiate updates following material regulatory changes, and manage annual reviews, approvals, and version history.
- Conduct monthly random-sample claims audits, track findings, escalate repeat findings, and implement and verify corrective actions.
- Design, deliver, and track annual compliance training and maintain staff attestation records and annual reports.
- Track overpayments, ensure investigation and classification, and coordinate refunds within the 60-day statutory deadline.
- Monitor state practice-act changes and grant compliance obligations as the organization enters government programs.
- Review SNF partner and vendor agreements against the Anti-Kickback Statute checklist and maintain contract files and review schedules.
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