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Overview

Tufts University School of Dental Medicine (TUSDM) offers one of the most forward-looking educational environments in dental medicine in the country. The School has established a formal institutional compliance program to help ensure that medical and dental services billed to Medicare and other third party payors are sufficiently documented and comply with applicable professional fee reimbursement regulations and guidelines. Because of complex and ever-changing regulatory requirements, the Federal Government has encouraged health care providers to vigorously educate its employees and establish a compliance program. The Compliance Officer, along with the other members of the Dental School, supports the education and clinical mission of the Dental School in this regard.

What You'll Do

• Oversees all activity related to the development, implementation, and maintenance of compliance with the organization’s policies and procedures, involving patient privacy and access to protected health care information
• Works with various constituents to ensure that all policies, procedures and protocols that govern the patient billing operations of the School and compliance with privacy regulations and school policy are implemented, up-to-date and enforced
• Enforces compliance with the Health Insurance Portability and Accountability Act (HIPAA) rules and regulations
• Ensures that the School of Dental Medicine’s potential for any non-compliance with billing or patient privacy regulations is minimized or prevented                                                                                  
• Develops good working relationships with key stakeholders across the School, including senior administrators, faculty, students, and staff, to ensure program governance
• Provides courteous, professional, and effective support services, thereby providing patients, students, faculty and staff with the information, training, and guidance necessary to achieve and sustain an effective compliance environment
• Meets regularly with the Tufts University Director, Internal Audit to keep the individual informed of compliance activities and to seek guidance and direction as needed   

What We're Looking For

Basic Requirements:

• Knowledge and skills as typically acquired through completion of a Bachelor’s degree and 7+ years of  compliance (Insurance billing and patient privacy regulatory) experience in the healthcare industry
• A proven track record of success in implementing the components of a strong compliance program
• Experience in compliance with dental and medical insurance billing, including Medicare and Medicaid
• Demonstrated knowledge of insurance carriers, Medicare and Medicaid reimbursement plans, commercial dental/medical, insurance coding and billing practices (third-party billing) and dental patient care systems
• Familiarity with ADA (dental) codes, ICD-9/10 and CPT Codes
• Experience in Microsoft Office, specifically Excel and Word

Preferred Qualifications:

• Certified Medical Compliance Officer (CMCO), Certified Professional Compliance Officer (CPCO), or 

  Certified in Healthcare Compliance (CHC) designation(s)

• Management experience in large organization
• MS/MBA or CPA or JD

Pay Range

Minimum $133,200.00, Midpoint $166,500.00, Maximum $199,800.00
 

Salary is based on related experience, expertise, and internal equity; generally, new hires can expect pay between the minimum and midpoint of the range.