LAB REG. COMPLIANCE SPEC
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.
Responsible for regulatory and compliance affairs to assure compliance with the requirements of federal agencies (CLIA, OSHA), state (Connecticut, , and accreditation groups (JCAHO, CAP) . Responsible for departmental and outside institutional CAP inspections. Consults on regulatory requirments for all the laboratory sections. Coordinates requests for research discounts. Requests billing codes for all areas in co-ordination with the system. Assists with Ellucid document control for all areas. Reviews daily billing work queues for all areas. Acts as a resource for billing and coding issues.
"Come Grow With Us"
- 1. Provides liaison with federal, state and private accreditation agencies and maintains necessary documentation in support of their requirements for accreditation and licensure.
- 2. Assist the Laboratory Administrative manager in all aspects of on-site inspections performed by CAP for accreditation, State of Connecticut for licensure, and CLIA for accreditation verification, with corresponding follow up with appropriate organizations correcting deficiencies received during inspections.
- 3. Responsible for CAP inspections of other institutions to include assembly of inspection team, scheduling, coordination of site visit, inspection oversight, and completion of documentation.
- 4. Remains current on laboratory regulatory and compliance requirements. Advises laboratory management on necessity for meeting any changes in these requirements.
- 5. Assures current chargemaster data is accurate.
- 6. Works with hospital billing staff to assure proper charging of tests.
- 7. Works EPIC billing queues daily for all laboratory sections.
- 8. Reviews ABN data and denials resolution daily
- 9. Works with patients to resolve billing complaints
- 10. Provides statistical information for various comparative studies and requests for client billing
- 11. Responsible for production, interpretation and dissemination of the Comparative Analysis reports detailing departmental charging and workload recording, and productivity data.
- 12. Performs all other job duties and responsibilities as required.
- 13. Maintains and updates departmental information regarding research discount requests.
Bachelors of Science Degree in Medical Technology or Clinical Laboratory Science with ASCP certification (or equivalent). Masters degree in healthcare or business or in progress preferred.
Five (5) or more years of relevant laboratory experience. Knowledge of Epic billing queues and CPT-4 coding. Experienced in document control.
MT or MLS (ASCP)
CAP certified instructor - must be revalidated every two years
Knowledge of laboratory operations and testing. Good organizational skills. Good writing skills. Proficient in word processing, database, and spread sheet applications. Liaison with government agencies and private accreditation groups. Knowledge of regulatory requirements of government agencies and private accreditation groups. Knowledge of laboratory billing principles and CPT-4 and corporate compliance around CMS billing.
See Inside the Office of Yale New Haven Hospital
Yale New Haven Hospital provides diverse comprehensive care in over 100 medical specialties. As the primary teaching hospital of the Yale School of Medicine, YNHH provides around-the-clock coverage and insightful, research-supported patient care. In addition to providing quality medical care to patients and families, Yale New Haven Hospital is the second largest employer in the New Haven area, with more than 12,000 employees.
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