Compliance Specialist - Compliance

Compliance Specialist – Compliance Join Maury Regional Health as a Compliance Specialist and put your analytical skills, attention to detail, and knowledge of healthcare regulations to work supporting ethical practices, regulatory compliance, and organizational accountability. Play an important role in identifying compliance risks, supporting accurate clinical and financial documentation, and strengthening our health system's commitment to integrity and patient trust while advancing our mission of delivering Clinical excellence.

Compassionate care. Every patient. Every day. Location Maury Regional Medical Center 1222 Trotwood Ave, Suite 400 Columbia, TN 38401 Shift Full-Time, Exempt Day Shift Job Summary The Compliance Specialist plays an essential role in supporting the integrity, accountability, and regulatory compliance of Maury Regional Health's healthcare operations.

This position contributes to the effectiveness of the organization's compliance program by helping identify and address potential risks while promoting ethical practices, accurate documentation, and adherence to applicable healthcare standards. As a valued member of the Compliance Department, the Compliance Specialist supports organizational transparency, responsible operations, and a culture of compliance that protects patients, employees, and the health system.

Responsibilities

Maintain current knowledge of healthcare compliance, privacy, coding, billing, reimbursement, and regulatory requirements through continuing education and professional resources. Plan and prepare compliance audits by researching applicable standards, establishing audit scope and methodology, selecting appropriate samples, coordinating with stakeholders, and defining timelines and deliverables.

Compliance Auditing and Documentation Review: Conduct risk-based audits of provider and facility coding, clinical documentation, charge capture, billing, reimbursement, and related processes. Evaluate medical records, patient financial accounts, claims, and supporting documentation for accuracy, completeness, coding support, and compliance with applicable laws, payer requirements, and organizational policies.

Audit Reporting and Compliance Education: Prepare accurate and comprehensive audit workpapers and reports documenting methodologies, records reviewed, supporting evidence, findings, conclusions, and recommendations. Communicate audit results professionally to providers, leaders, and staff while providing education on regulatory requirements, identified risks, and recommended corrective actions.

Corrective Action and Ongoing Monitoring: Assist in developing, implementing, and monitoring corrective-action plans to address identified compliance concerns. Conduct follow-up reviews to verify that corrective actions have been completed, remain effective, and support sustainable improvements in compliance practices.

Compliance Investigations and Risk Analysis: Support compliance and privacy reviews, monitoring activities, and investigations by gathering and analyzing relevant information, documenting findings, and escalating suspected violations, control weaknesses, and potential overpayments. Collect, validate, and analyze compliance-related data to identify trends, anomalies, and emerging regulatory, billing, operational, or privacy risks.

Compliance Program Administration and Support: Serve as a resource for compliance technology systems and the organization's policy and procedure repository. Support exclusion and sanction screenings, compliance and privacy education, policy administration, regulatory reporting, special projects, and the secure maintenance of confidential compliance records.

Qualifications

Associate Degree (Preferred) Certification in Healthcare Compliance and Healthcare Privacy (Preferred) Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Certification (Preferred) 3 Years of Healthcare Compliance Experience (Preferred) 2 Years of Computer Systems/Application Experience (Preferred) 2 Years of Healthcare Compliance Experience (Preferred) Why Maury Regional Health Join an award-winning health system committed to serving the healthcare needs of southern Middle Tennessee!

Benefit-eligible positions include: Comprehensive Medical, Dental, and Vision plans Employer-paid life insurance Retirement savings plan with employer-matching Paid Time Off (PTO) Educational Assistance, Tuition Reimbursement and Student Loan Forgiveness Career advancement navigation opportunities Adoption assistance services Financial planning programs Maury Regional Health is committed to the principles of Equal Employment Opportunity in all aspects of the employer/employee relationship.

Maury Regional Health grants equal employment opportunities to all qualified persons without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), national origins (including ancestry), genetic information, disability, age, military/national guard/veteran status, sexual orientation, gender identity, or gender expression, or other status protected by state or federal law.

Statements made by applicants for employment on this application form will be checked for accuracy. Maury Regional Health campuses are tobacco-free. All tobacco use is prohibited.