Compliance Specialist (Registered Nurse - RN)Posted: October 11, 2009
Description: - Compliance Specialist (Registered Nurse - RN) (FIN0000P) Job Description Compliance Specialist (Registered Nurse - RN)-FIN0000P Description Maxim Healthcare Services is one of the leading providers of medical staffing, home health and wellness services in the United States. Founded in 1988, Maxim has rapidly expanded to include 12 divisions and over 400 branch offices in 44 states and the District of Columbia. We have earned a position as an innovative leader in the healthcare industry through our emphasis on patient care and customer service. Today, Maxim is one of the largest privately owned companies in our industry. We are currently seeking qualified applicants for the role of a Compliance Specialist. The Compliance Specialist must maintain a comprehensive understanding of ethical principles and independence in their work product maintaining the highest level of personal and professional conduct, duty and responsibilities. This individual is obligated to articulate principles, have a working knowledge of the rules and regulations as they pertain to all aspects of home healthcare, and monitor to the highest level of professional standards, quality care and legal aspects. Essential Duties and Responsibilities include: * The primary responsibility of the position is to review clinical medical records and claims for accuracy of services related to clinical standards of practice and care, levels of care, quality indicators, medical necessity, lengths 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. * Contributes to weekly conference calls and team meetings. * Maintains current knowledge of rules, regulations and reimbursement issues. * Contributes to policy and procedure development as requested. * Ensures confidentiality of medical information as related to the HIPAA regulations. * Displays dedication to the corporate objectives. * Perform 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. * Submits all expense reimbursement requests within 30 days of a site visit. Qualifications Minimum Requirements: * RN/ BSN or other commensurate healthcare degree. * 5+ years Clinical experience, Critical Care/Home Healthcare preferred. * A comprehensive understanding of Chart-to-Bill audits. * Experience in Utilization Review, Risk Management, Quality Management, Documentation Specialist, Nurse Manager, Compliance, Billing, Coding experience or CFE, LNC or CPUR certification. * Demonstrated knowledge of Clinical Compliance, Best Practices, Medical Record Review, Legal Aspects of Documentation. * Demonstrated knowledge of CPT, ICD-9 codes, DRGs and APC coding . * Understanding of all payer rules and regulations, including Medicare and Medicaid. * Ability to set priorities and meet time lines for performance expectations; work independently with minimal supervision and demonstrates initiative. * Excellent interpersonal and communication skills. * Demonstrates sound judgment and decision-making. * Demonstrate the ability to articulate rationale and to deliver difficult messages in a constructive manner; is diplomatic in the face of adversity; Must be ethical and possess the ability to remain impartial and objective. * Must be detail-oriented. * Proficient with computers and programs such MS Office, Excel, Word , email and internet research * Must possess the ability to educate and train on Compliance and Clinical standards to staff members. * Must be able to travel at least 50% of the work time. Our company is committed to maintaining a challenging environment that promotes personal accountability, personal growth, and an active role in the driving vision of the company. We offer competitive pay, full benefits including medical, dental and vision coverage as well as 401(k), 529 college savings plan, basic life insurance with the option of supplemental and 17 days paid time off in addition to holidays. To learn more about Maxim Healthcare Services, please visit our website www.maximhealthcare.com and apply online at www.joinmaxim.com. EOE/AAE Keywords: RN, Registered Nurse, Nurse, nursing, homecare, home care, healthcare, health care, home health, home healthcare, med surge, ER, Emergency Room, ICU, intensive care unit, NICU, hospice, RN case manager, RN clinical supervisor, , r.n., rn, acute care, homecare manager, home care manager, clinical director, clinical administrator, patient care manager, director of nursing, DON, DOCS, field case manager, field clinical supervisor, director of clinical services, RN manager, registered nurse manager, RN supervisor, registered nurse supervisor, nurse management, nurse manager, RN director, registered nurse director, visit nurse, admission nurse, skilled visit, case management, pediatric clinical supervisor, pediatric case manager, home care nurse, homecare nurse, home health nurse, staff nurse Job Finance Primary Location NJ-North Brunswick Schedule Full-time Job Level Individual Contributor Education Level Bachelors Degree (16 years) Shift Day Job Job Posting Send this job to a friend Send this job description to a friend by email. All the relevant details will be included in the message.Send this job to a friend Please refer to job code 114743 when responding to this ad.
| Category: | Healthcare/Social Services |
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> Registered Nurse (RN)
| | Location: | North Brunswick, NJ | | County: | Middlesex County | | ZIP Code: | 08902 | | Pay Rate: | Open | | Job Terms: | full time | | Company: | Maxim Healthcare Services | | Phone: | email only please | | Fax: | email only please |
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