Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

The Compliance Coordinator identifies and assesses billing compliance, operational and financial risks acrossthe Kettering Health Network and within the employed physician network, Kettering Physician Network (KPN).The Compliance Coordinator audits and monitors departments and physician practices for compliance withexisting policies and governmental regulations. Develops compliance and education plans, policies andprocedures that affect operations and assure recommendations to minimize risk are implemented timely andeffectively. Monitors new government compliance rules and regulations affecting patient billing in all facilitiesand physician offices. Reports directly to Network Director of Compliance Operations.

Job Responsibilities

The job duties of the Compliance Coordinator role include, but are not limited to, the following:

1. Auditing and monitoring hospital departments and/or employed physician practices for billing and coding compliance in accordance with payer requirements and providing education to internal clients based on audit findings;
2. Supporting the development and communication of Kettering Health’s compliance and monitoring plan;
3. Assist with drafting healthcare compliance-related policies and procedures;
4. Supporting the assignment and investigation of hotline concerns submitted to the compliance department;
5. Researching, as needed, various issues related to Stark law, the Anti-Kickback Statute, EMTALA, False Claims Act, provider-based rules, conflicts of interest and beneficiary inducement; and
6. Reviewing/auditing physician payments for contractual compliance.

Job Requirements

• Has or is able to complete and pass coding certification with 12 months of hire (CPC or CCS-P)

• Excellent interpersonal and organizational skills, an ability to positively influence, prioritize, meet important deadlines, work independently, and work interdependently.
• Proficiency with Microsoft Office suite, precision and accuracy in data collection, and excellent oral and written communication skills.
• This role must collaborate with individuals at different professional levels and appropriately handle confidential information.