Assistant Integrity Officer

Description:

Function/Duties of Position:

• Act as a resource to clinical areas on compliance issues. This may include researching laws, rules and regulations; seeking legal advice; meeting with appropriate individuals; developing action plans and time lines, and assisting with implementation. Work with Human Resources to ensure that compliance

  policies and procedures are enforced through appropriate and consistent disciplinary action. Continually reinforces and communicates importance of compliance to employees at all levels of the hospitals and clinics.

• Monitor regulatory developments and OHSU operational changes; keeps current on rules, regulations, and advances in the field of compliance; clarifies government rules with appropriate parties and entities. Educates and communicates to stakeholders government regulations and their impact on Healthcare System practices

• Conduct reviews and audits of clinical risk areas particularly as identified by the HHS Office of the Inspector General using self-assessment questionnaires, verification procedures, and internal audits. Draft reports and recommendations of reviews and audits. Work with internal auditors and OHSU Legal department as necessary.

• Conduct follow-up audits of previous compliance issues to verify plan of actions have been implemented and followed.

• Assist newly-credentialed/privileged physicians, non-physician practitioners with assessing clinical activities and determining billable services. Evaluate the medical necessity of encounters, and level of care. Periodically reviews clinical services performed to ensure compliance with laws, rules and regulations. This would Include reviewing medical records for compliance with documentation, coding, and billing requirements. Seek legal advice as necessary. Educate providers concerning laws and regulations and applicability to OHSU environment.

Required Qualifications:

Education:

• Bachelor's degree or equivalent experience.

Experience:

• Five years experience with clinical documentation, billing and coding.

Job Related Knowledge, Skills and Abilities:

• Familiarity with a high complex administrative and financial environment.
• Strong interpersonal skills and evidence of previous success in dealing with staff (at all levels) including nurses, non-physician practitioners, physicians, and management.
• Knowledge of inpatient and outpatient professional documentation, coding, billing requirements in an academic health center that or a large outpatient component.
• Excellent interpersonal, writing and public speaking skills.
• Ability to work independently, take initiative, exercise sound judgment, and meet deadlines.
• Maintain confidentiality where appropriate; able to participate in extremely sensitive situations.
• High degree of accountability, honesty and integrity.