Healthcare Compliance Specialist Job Description, Key Duties and Responsibilities

Healthcare Compliance Specialist Job Description, Key Duties and Responsibilities

This post gives complete information on the job description of a healthcare compliance specialist to help increase your knowledge of what they do.

It highlights the key duties, tasks, and responsibilities that commonly make up the healthcare compliance specialist work description in most organizations.

This post also provides the major requirements most recruiters will want individuals seeking the healthcare compliance specialist position to fulfill to be hired.

Please, continue reading to learn more about the healthcare compliance specialist career:

What Does a Healthcare Compliance Specialist Do?

The healthcare compliance specialist assists the Corporate Compliance Department or organization with the administration of their corporate compliance program and policies, as well as ensures that practices are within a reasonable and appropriate level of compliance with the HIPAA Privacy Rule and standards dealing with Personally Identifiable Information (PII).

They also work with the CCO to ensure appropriate non-technical safeguards with respect to Protected Health Information (PHI), as well as other proprietary and sensitive information are in place.

They work closely with the leadership of the corporate compliance department on programs, processes, and systems.

The healthcare compliance specialist job description involves auditing, monitoring, tracking, trending, and reporting compliance with state, federal, and other regulatory requirements; managing and reducing compliance risks.

It also entails facilitating compliance awareness and conducting trainings to promote a culture of compliance across the health system.

Healthcare compliance specialists are responsible for providing service, support, and advice in response to the changing needs of the organization, healthcare laws, and governmental policies.

They also prepare the necessary documentation for the intake of privacy and other compliance related issues daily, and assist CCO in conducting investigations and preparing privacy and compliance investigation reports as required.

They are responsible for providing a periodic report of sanction checks for all employees, contractors and vendors, and also ensure that all individuals and entities providing service to or on behalf of the organization have not been excluded from participating in federally funded health care programs.

The healthcare compliance specialist work description also involves preparing educational materials and presentations for Privacy and Compliance for annual and focused training as needed.

Healthcare Compliance Specialist Job Description Example/Sample/Template

The healthcare compliance specialist performs various functions, including setting the tone for compliance in the organization, educating the employees, and providing guidance on compliance-related issues.

The daily tasks, duties, and responsibilities that majorly make up the healthcare compliance specialist job description are listed below:

• Responsible for coordinating or facilitating compliance meetings
• Carry out special projects and research to track trends and analyze deliverables and data to identify impacts and potential efficiencies
• Collect information and provide a variety of reports and analyses to monitor and evaluate projects and programs
• Responsible for the review and assessment of submissions for proposed actions or expenditures related to healthcare professionals, medical institutions and other government officials to ensure compliance with the organization’s policies and procedures
• Stay abreast with the US Healthcare Compliance laws, regulations, and enforcement environment, and understand how they impact the organization
• Provide guidance to employees on the organization’s compliance policies and programs, and also educate staff on applicable compliance rules, regulations, and best practices
• Collaborate with other departments, including Sales, Marketing, Finance, Legal, Regulatory, Medical Education and Clinical departments
• Manage compliance matters and risk in a professional manner
• Responsible for the preparation of compliance presentations and reports such as incident and training metrics
• Encourage a zero-tolerance environment where fraud or non-compliance is unacceptable
• Conduct regular review of policies, training, and communications, and other components of the compliance program to ensure continuous improvement.

Healthcare Compliance Specialist Job Description for Resume

If you have worked before as a healthcare compliance specialist or are presently working in that role and are making a resume for a new position, you can create the professional experience section of your resume by using the job description sample above.

It is important to have a professional experience section in your resume to show to the recruiter that you have the required healthcare compliance specialist work experience, which can give your resume a boost.

You can adopt the duties and responsibilities of a healthcare compliance specialist presented in the above job description example in making the professional experience part of your resume.

Healthcare Compliance Specialist Requirements – Skills, Knowledge, and Abilities for Career Success

If you are seeking the job of a healthcare compliance specialist, you will need to meet the recruiter’s requirements to be considered for hiring.

Recruiters generally look for candidates who can effectively carry out the obligations, purpose, and objectives of the healthcare compliance specialist role.

They will seek to find such candidates by setting certain requirements to screen all applicants.

Shown below are major requirements that individuals seeking the healthcare compliance specialist job may be expected to fulfill before they are considered for employment:

• Education: Applicants for the healthcare compliance specialist position are commonly required to have minimum of Bachelor’s degree in Healthcare, Business, Legal, Accounting, or Finance, or in a related field
• Certification: In addition to a Bachelor’s degree, it is also important that they are certified by the Compliance Certification Board. Compliance Certification, such as certified Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP), etc. is required
• Knowledge: A healthcare compliance specialist should be conversant with healthcare laws and regulations. They should also have a comprehensive understanding of ethics in a healthcare environment. Also, employers are often interested in people with experience in any of the following: Compliance, legal, internal audit, or risk management, or similar regulatory/investigatory role for the healthcare compliance specialist position
• Analytical skills: The healthcare compliance specialist may be required to conduct complex and sensitive compliance and fraud investigations, so it is important that they have strong analytical and highly developed technical skills to carry out such investigations
• Interpersonal skills: It is also important that they can relate with people from various backgrounds, establish rapport, and manage relationships effectively. Having good relationship with people in the workplace makes it easier to influence their actions and provide guidance to them on compliance-issues
• Communication skills: The healthcare compliance specialist job involves providing education, counsel, and reports on compliance related issues. So it is important that they have exceptional written and oral communication skills to enable them prepare and deliver training and education to small and large groups
• Computer skills: Applicants for the healthcare compliance specialist position should be able to use computer applications such as Microsoft Word, Excel, and Power Point
• Organizational skills: It is also important that they plan and organize effectively to enable them handle multiple projects and demanding workload effectively, as well as meet deadlines associated with their job. They must also have the capacity to translate strategies into goals and action plans, and execute the plans within the stipulated time-frame.

Healthcare Compliance Specialist Salary

The salary for a healthcare compliance specialist position depends on factors like the size of the employer, location, and the employee’s years of experience.

The national average salary for this position is $59,746 per annum in the United States. But, with the advancement in individual skill and more years of experience, the pay may be as high as $85,000.

Conclusion

If you are a recruiter or HR manager needing to hire for the healthcare compliance specialist role, you will need to make a description of the job available to prospective candidates to help them learn about the duties they will be expected to perform if hired.

You can make the perfect description for the vacant healthcare compliance specialist job in your organization by applying the sample job description provided above.

This post is also helpful to individuals who are interested in the healthcare compliance specialist career; they will be able to increase their knowledge of the duties and responsibilities majorly performed by the role.