EMS Compliance Officer

JOB SUMMARY

Reporting directly to the Emergency Medical Services Director, responsible for directing and coordinating the department’s efforts to ensure compliance with state and federal laws, regulations, and policies.

EXAMPLES OF WORK PERFORMED

• Serves as a member of the department executive team to plan, develop, recommend, resolve, and implement executive level policies and procedures
• Serves as Chair of the Compliance Committee
• Provides internal contract policy review and revision to assure up to date contracts and compliance
• Reviews and enforces Texas Department of State Health Services regulatory requirements
• Verifies that all policies, procedures, and guidelines have been documented, implemented and communicated
• Researches areas of non-compliance, formulates an improvement plan, and facilitates system wide education to staff members
• Provides up to date knowledge of health care compliance laws and regulations that govern the ambulance industry
• Reviews patient care records assuring required Medicare/Medicaid forms are complete
• Provides oversight to workflow processing of patient care reports, attachments, and billing corrections
• Coordinates and oversees the filing of regulatory forms, submissions, and reporting activity
• Coordinates and oversees employee sanction verification and certification status
• Coordinates, oversees, and submits cost reporting for Texas ambulance supplemental payment program and Medicare Ground Ambulance Data Collection System as mandated
• Performs routine billing and documentation audits
• Develops and facilitates the quality assurance (QA) and billing compliance programs
• Develops and facilitates documentation training, quality assurance, and billing compliance updates for staff
• Serves as a liaison to county auditors during annual billing audits
• Serves as department liaison to resolve escalated patient billing concerns
• Assures billing performance is in compliance with contracts, billing guidelines, write-off policy, and federal laws
• Creates and implements educational programs related to compliance
• Serves as department representative for billing audit mitigation, investigation, and resolution
• Responsible for risk assessment and improvement activities related to compliance
• Coordinates quarterly access controls with third party billing vendor
• Maintains and coordinates access to payor portals including Medicare, Medicaid, Veteran Affairs, and commercial access
• Attends meetings, conferences, workshops, and training sessions and reviews publications and audio-visual materials to become and remain current on principles, practices, and new developments in assigned work areas on the state and federal level

• Performs special duties as assigned

ORGANIZATION RELATIONSHIPS

• Reports directly to – Emergency Medical Services Director
• Direct Reports – No

PHYSICAL DEMANDS

• Position involves safely operating a motor vehicle and emergency equipment
• Position involves prolonged sitting, standing, walking, reaching, twisting, turning, kneeling, bending, lifting, climbing, squatting, and stooping in the performance of daily activities
• Position involves hearing audible sounds and speaking in a clear, understandable voice
• While performing the duties of this job the employee is frequently required to:
  • Sit; talk and hear; use fingers, hands and arms to handle, reach and/or operate basic office equipment, objects, tools or controls
  • The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl; and smell
  • The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 40 pounds
  • Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception and the ability to adjust focus

ENVIRONMENTAL FACTORS

• Work is primarily indoors in an air-conditioned office
• May be required to work in inclement weather, including extreme heat, cold and wet conditions

IRREGULAR HOURS

• Work outside of the normal office hours (Monday-Friday 8 a.m. to 5 p.m.) may be required
• Essential personnel for emergency situations; discretion of department director
• Regular attendance is required

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel so classified in this position. This job description is subject to change as the needs and requirements of the job change.

MINIMUM QUALIFICATIONS

• Bachelor’s degree in a related field or an equivalent combination of education and experience
• Five (5) years of related compliance/auditing experience

• Prior knowledge and experience working in the healthcare insurance industry

LICENSES AND CERTIFICATIONS

Required within thirty (30) days of employment

• Valid driver’s license

PREFERRED QUALIFICATIONS

• Prior experience working with Medicare, Medicaid, private health, and auto Insurance policy provision and processing
• Knowledge and training in federal and state law regulations and billing compliance standards
• Knowledge and experience in audits and investigations
• Knowledge of electronic billing and electronic patient care reporting
• Knowledge of cost analysis, cost reporting and revenue cycle management

• Certified or licensed by the Texas Department of State Health Services as a paramedic
• Certified Ambulance Coder

EMPLOYMENT TESTING

Employment is contingent on passing any post-offer pre-employment screening as listed below:

• Criminal background check: Yes
• Motor Vehicle Record check: Yes
• Drug screening: Yes
• Physical exam: No
• Psychological exam: No
• Additional: Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) database clearance

SUPPLEMENTAL INFORMATION

A Williamson County online application (resumes alone are not sufficient) must be received before the position is closed. Positions are open until filled, subject to close at any time after five (5) calendar days. The Human Resources Department is located at 100 Wilco Way, Georgetown, TX 78626. Phone (512) 943-1533 or visit our website at www.wilcotx.gov/469/Human-Resources.

Williamson County is an Equal Opportunity Employer and complies with the Americans with Disabilities Act and Uniformed Services Employment and Reemployment Rights Act (USERRA). If you require an accommodation in order to apply for a position, please request assistance from the Human Resources Department.

TOBACCO FREE WORKPLACE POLICY

Williamson County is a tobacco free workplace. The use of tobacco products (e.g., cigarettes, cigars, pipes, snuff, chew, etc.) and Electronic Nicotine Delivery Systems (ENDS) (e.g., vapor, e-cigarettes, etc.) is prohibited on all Williamson County premises. Employees who violate this policy are subject to appropriate disciplinary action up to and including termination of employment.

Williamson County offers a full range of employee benefit programs for eligible full-time employees, retirees, and their families. These programs include group health plans for medical and dental coverage; an Employee Assistance Program (EAP); life; short- term disability and long-term disability insurance; and flexible spending accounts for health care and dependent care reimbursements.

To review our benefit options and associated costs, click here to visit our interactive benefits cost estimator.

The County also provides retirement benefits. Full-time & part-time employees participate in the Texas County & District Retirement System (TCDRS), and employees may also participate in a retirement savings program (Deferred Compensation). In addition to these basic employee benefits and retirement services, employees benefit from a variety of other programs including 12 paid holidays. For more details please contact Williamson County Human Resources at 512-943-1533.

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