Privacy and Compliance Officer (7398U), Optometry 33255



Privacy and Compliance Officer (7398U), Optometry 33255 About Berkeley

At the University of California, Berkeley, we are committed to creating a community that fosters equity of experience and opportunity, and ensures that students, faculty, and staff of all backgrounds feel safe, welcome and included. Our culture of openness, freedom and belonging make it a special place for students, faculty and staff.

The University of California, Berkeley, is one of the world's leading institutions of higher education, distinguished by its combination of internationally recognized academic and research excellence; the transformative opportunity it provides to a large and diverse student body; its public mission and commitment to equity and social justice; and its roots in the California experience, animated by such values as innovation, questioning the status quo, and respect for the environment and nature. Since its founding in 1868, Berkeley has fueled a perpetual renaissance, generating unparalleled intellectual, economic and social value in California, the United States and the world.

We are looking for equity-minded applicants who represent the full diversity of California and who demonstrate a sensitivity to and understanding of the diverse academic, socioeconomic, cultural, disability, gender identity, sexual orientation, and ethnic backgrounds present in our community. When you join the team at Berkeley, you can expect to be part of an inclusive, innovative and equity-focused community that approaches higher education as a matter of social justice that requires broad collaboration among faculty, staff, students and community partners. In deciding whether to apply for a position at Berkeley, you are strongly encouraged to consider whether your values align with our Guiding Values and Principles, our Principles of Community, and our Strategic Plan.

Departmental Overview

At Herbert Wertheim School of Optometry & Vision Science at the University of California, Berkeley, we have long lived by defining principles that guide us and differentiate us. As a part of a world-renowned university that embraces excellence and access, we foster an environment of trust and mutual respect, free expression and inquiry, and personal resilience and achievement. We are strongly committed to diversity, respect for cultural differences, and promoting social justice. These principles serve us daily in our reasonings and actions and aid us in our decision making. We educate an estimate 320 students annually. Our O.D. program is a 4-year program with clinical training provided at 2 campus clinics, 10 satellite clinics (community care), 7 VA clinics, and 24 external clinics across the country. Our one-year post-graduate residency programs provide advanced clinical education in specialty areas of optometry to 18 residents with placement on and off campus, and our Vision Science program consists of 40 PhD students.

Application Review Date

The First Review Date for this job is: April 13, 2022.

Responsibilities

The Compliance Officer under the direction of the Associate Dean establishes and implements an effective compliance program to prevent illegal, unethical, or improper conduct. The Compliance Officer acts as staff to the Associate Dean of Clinical Affairs by monitoring and reporting results of the compliance and ethics programs and procedures of the Clinic and in providing guidance for the management team on matters relating to reporting and regulatory compliance, especially billing of third party (insurance) payers, HIPAA and Privacy policies. The Compliance Officer, together with the clinic leadership team, is authorized to implement necessary actions to ensure achievement of the objectives of an effective compliance program. This position also serves as the Privacy Officer for the Herbert Wertheim School of Optometry & Vision Science at the University of California, Berkeley eye clinics.

Key responsibilities include:

Compliance and Privacy Oversight
  • Maintain all regulatory standards including Joint Commission, HIPAA, California Department of Public Health (CDPH), Family Educational Rights and Privacy Act (FERPA) and California's Child Abuse and Neglect Reporting Act (CANRA). Maintain and update all HIPAA and FERPA compliance policies and procedures. Create and maintain all training and educational material as regulations change.
  • Provides management oversight of compliance systems and processes that protect assets from financial loss and ensure compliance with established requirements at the state and federal level.
  • Participate in Joint Commission compliance activities such as Joint Commission on Accreditation of Healthcare Organizations accreditation processes.
  • Maintain current knowledge of applicable federal and state privacy laws
  • Oversee the development and implementation of UC Optometry Clinic policies and compliance therewith and procedures for carrying out the requirements of the University's system wide HIPAA standards and implementation Policies and the education of UC Optometry Clinic workforce with respect to the federal Privacy Rule.
  • Review documents prior to release of personal health information in response to requests from Risk Management, External Auditors, Recovery Audit Contractors, Subpoenas, or other third parties etc. Establish the institution of a regular audit of access to and use of Personal Health Information (PHI) to ensure the Minimum Necessary Rule is being upheld.
  • Provides input into non-technical portions of contract proposals for insurance vendor contracts.
  • Maintains Business Associate Agreements (BAAs) insuring they are current and in compliance with federal, state and university regulations, rules and policies.
  • Acts as member and secretary to Optometry's HIPAA Steering committee
  • Evaluates the organization's existing policies and procedures for HIPAA compliance by performing HIPAA risk assessments.
  • Develops and assists with implementation of new and updated policies and procedures.
  • Maintains policies and procedures related to PHI access and use; ensures strict adherence by all staff with access to PHI.
  • Assesses methods and procedures used to store and transmit PHI; identifies security or other compliance risks and researches and recommends improvements.
  • Maintains required records and supporting documentation including authorization forms, notices, and plan documents.
  • Communicates with individuals regarding their right to inspect, amend, and restrict access to their PHI.
  • Drafts and implements procedures for addressing and resolving complaints regarding the organizations privacy policies and procedures.
  • Serves as the internal subject matter expert on HIPAA, maintaining current knowledge of HIPAA laws and regulations, and any other applicable federal and state privacy laws or regulations.
  • Reports on changes in applicable laws and regulations and provides training as needed.
  • Builds and manage a strategic and comprehensive privacy program that defines, develops, maintains and implements policies and processes that enable consistent, effective privacy practices which minimize risk and ensure the confidentiality of protected health information (PHI), paper and/or electronic, across all media types. Ensures privacy forms, policies, standards, and procedures are up-to-date.
  • Works with organization senior management, security, and corporate compliance officers to establish governance for the privacy program.
  • Establishes, with the information security officer, an ongoing process to track, investigate and report inappropriate access and disclosure of protected healthcare information. Monitor patterns of inappropriate access and/or disclosure of protected health information.

Credentialing
  • Maintain and update our credentialed providers, including our Residents.
  • Manage and maintain insurance logins including updates to our profile information such as contact information.
  • In partnership with IT, ensure our systems are updated with the most accurate fee and provider information.

Health Information Management Oversight
  • Responsible for the acquisition, analysis, storage, retrieval and release of medical and related information.
  • Responsible for in depth working knowledge of clinic systems such as Eyecare Advantage for Compulink, including upgrade needs assessments, accessibility and limitations.
  • Responsible for onboarding and training faculty, staff and students on the use of our internal systems and policies and procedures.
  • Facilitates the flow of patient health information throughout the school's eye clinics, working with directors and managers to identify information needs and establish processes for efficient transfer of information.
  • Manage Medical Records Requests
  • Manage operations of the medical records requests, including transitioning to electronic medical record, maintenance and retention.
  • Ensure efficient operation through active management of workflow
  • Orient new clinical staff to the medical records and electronic medical record procedures
  • Manage electronic medical record changes and updates which may require redefining the workflow of the unit, re-training of staff and defining security permissions in our clinic systems.
  • Manage Release of Information Requests
  • Ensure that release of information is performed in accordance with federal and state laws and University policies. Review any complex or non-standard subpoenas, court orders or other requests received by the Release of Information Specialist
  • Maintain knowledge of applicable regulations through continuing education.
  • Develop policies and procedures in accordance legal requirements for release of information
  • Serve as consultant to clinical staff and administrators concerning use and disclosure of protected health information
  • Oversee all scan and imaging operations to ensure that the integrity of the Electronic Medical Record is maintained and documentation is easily retrieved for review or released. Manage medical record workflow, hold regular staff meetings to discuss ongoing changes and update employees on departmental policies, procedures and process improvement. Oversee activities of contractors and short term interns to ensure contract compliance.
    Audits Claims Billing Function
    • Develops and implements billing compliance program
    • Responsible for development and documentation of billing audit procedures
    • Works closely with IT and billing departments along with clinic management to ensure billing policies and process meet current Federal, State and University guidelines and procedures
    • Audit Claims for accuracy and timely submission.
    • Assists in the development of communication tools for the anticipated upcoming changes to medical coding, clinical documentation and electronic charge capture. Assume responsibility for additional anticipated needs with respect to supplies, training, scheduling, and data collection for the roll-out of the project as needed.

    Assist with patient staff, faculty and student communications
      Reviews and responds to patient customer service e-mails, phone calls and distributes and responds to complaints, compliments etc as appropriate. Coordinates with Clinic Administration and/or Patient Services to ensure that absence requests for students, residents, and faculty are processed and necessary schedule adjustments both on the absence reporting platform as well as the EHR have been made, and helps Clinic Administration and/or Patient Services ensures there is adequate coverage when personnel are absent. Understands clinic absence and make-up policy, and effectively communicates with students, residents, staff, and faculty. Triages situations and forwards issues presented by staff, faculty, students, and external constituents to appropriate staff member for resolution.

    Other duties as assigned
      Coordinates efforts with a variety of external and internal contacts; researches organizational structures, policies and procedures and summarizes best practices in field. Performs ad hoc, analytical studies on a wide variety of policies, programs and issues which are complex in nature. Researches and analyzes processes, procedures, policies and organizational structures in order to develop and/or implement changes and to provide consultative services regarding general management to department administrators. Prepares directives, regulations and other instructions for issuance to departments. Coordinates implementation with departments that cross organizational lines as needed. Researches and drafts complex proposals, reports, briefings, executive summaries, speeches Establishes and maintains contacts internally and with external constituents for the collection and exchange of data.

    Required Qualifications
    • Demonstrated experience working in clinical health care administration.
    • Demonstrated experience with health insurance plan administration.
    • Expert knowledge of HIPAA Privacy Rule and California state laws regulating privacy and confidentiality of health information.
    • Strong communication and interpersonal skills to communicate effectively with all levels of staff; both verbally and in writing.
    • Strong skills in analyzing and synthesizing large amounts of data for preparing sound and relevant proposals.
    • Ability to multi-task with demanding timeframes.
    • Ability to use discretion and maintain all confidentiality.
    • Strong skills in short term planning, analysis and problem-solving and customer service.
    • Strong collaborative and communication skills to interface departmental services with other faculty, staff, student and community programs.
    • Demonstrated initiative, resourcefulness.
    • Demonstrated ability to work with and in a diverse environment.
    • Experience or ability to learn how to research and analyze regulations, legislation, research literature and UC policies for impact on the organization or initiative. Strong policy analysis techniques.
    • Experience developing proposals and recommendations to guide and support a broader strategic direction for the organization or initiative.
    • Experience coordinating efforts with a variety of external and internal contacts; researching organizational structures, policies and procedures and summarizes best practices in field.
    • Experience providing technical guidance and quality assessment.
    • Demonstrated ability to perform ad hoc, analytical studies on a wide variety of policies, programs and issues which are complex in nature.
    • Demonstrated ability to develop and / or implement changes and to provide consultative services to department administrators, partners and external stakeholders
    • Experience with EHR/EMR systems such as Compulink, Compulink for Eyecare Advantage, Epic.

    Education/Training:
    • Bachelor's degree in related area and/or equivalent experience/training

    Preferred Qualifications
    • Experience working with government medical insurance, private medical insurance and vision insurance plans.
    • Experience working in a large medical practice with over 60 providers.
    • Experience working in an Optometry or Ophthalmology practice

    Licenses or certifications, if any:
    • Certified Professional Coder or Certified Professional Biller (Preferred)
    • Certified Compliance Officer (Preferred)
    • Certified Professional Medical Auditor (Preferred)

    Salary & Benefits

    This is an exempt, monthly paid position. Annual salary is commensurate with experience.

    For information on the comprehensive benefits package offered by the University visit:

    https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

    How to Apply

    Please submit your cover letter and resume as a single attachment when applying.

    Conviction History Background

    This is a designated position requiring fingerprinting and a background check due to the nature of the job responsibilities. Berkeley does hire people with conviction histories and reviews information received in the context of the job responsibilities. The University reserves the right to make employment contingent upon successful completion of the background check.

    Equal Employment Opportunity

    The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. For more information about your rights as an applicant see:

    https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
    For the complete University of California nondiscrimination and affirmative action policy see:
    http://policy.ucop.edu/doc/4000376/NondiscrimAffirmAct



    To apply, visit https://careerspub.universityofcalifornia.edu/psp/ucb/EMPLOYEE/HRMS/c/HRS_HRAM.HRS_APP_SCHJOB.GBL?Page=HRS_APP_JBPST&Action=U&FOCUS=Applicant&SiteId=21&JobOpeningId=33255&PostingSeq=1





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