Compliance Manager

Overview The Compliance Manager is responsible for overseeing regulatory, clinical, and operational compliance across Retina Consultants of South Carolina, with added responsibility for IT-related compliance and audit management. This role ensures adherence to federal and state regulations, protects patient data, supports secure and compliant use of technology, and manages internal and external audits while promoting a culture of accountability, patient safety, and continuous improvement. Responsibilities Regulatory & Compliance Program Oversight Develop, implement, and maintain a comprehensive compliance program for the company Ensure compliance with HIPAA, OSHA, CMS, Medicare/Medicaid, and applicable state regulations Monitor ophthalmology-specific regulatory and payer requirements Track regulatory changes and translate them into operational guidance Clinical & Operational Compliance Provides leadership and support for the clinic office staff and physicians Conduct scheduled and unannounced audits of ophthalmology clinics (clinical workflows, documentation, safety, and equipment) Review medical records and clinical documentation for compliance and accuracy Monitor infection control standards, exam room readiness, and equipment protocols Partner with leadership to implement corrective action plans and monitor follow‑through Prepare clinics and departments for audits, including documentation review and staff readiness Track audit findings, corrective action plans, and resolution timelines Report audit results, trends, and risk assessments to executive leadership Provide on‑site training for all staff on best practices Work closely with EHR systems for any system changes, outages, or updates Assist the accounting department with real estate projects Coding Compliance Collaborate with billing teams to ensure accurate coding, documentation, and modifier usage Monitor ophthalmology-specific CPT, ICD-10, and payer policies Support investigations of denials, payer audits, and billing-related risks Conduct Scribe meetings for relevant information IT & Data Security Responsibilities Serve as a liaison between Compliance, IT vendors, and clinic leadership Support HIPAA Security Rule compliance related to electronic protected health information (ePHI) Monitor access controls, user permissions, and role‑based system access Assist with oversight of EHR systems, imaging software, and practice management platforms Support cybersecurity initiatives, including password standards, device security, and secure remote access Participate in incident response related to data breaches, system outages, or security events Ensure IT‑related policies and procedures are documented, followed, and audited Provide regular compliance and audit status reports to leadership Controls security access for all buildings Qualifications Bachelor’s degree in healthcare administration, compliance, information systems, or related field required 3-5 years of healthcare compliance experience required Experience in ophthalmology or clinical settings strongly preferred Working knowledge of HIPAA Privacy & Security Rules, healthcare IT systems, and audit processes Strong analytical, organizational, and documentation skills Ability to manage multiple audits and initiatives simultaneously Excellent communication and interpersonal skills Compensation $70,000 - $95,000 per year #J-18808-Ljbffr