Compliance Analyst

>> We offer our team the best <<

• Medical, Dental and Vision Benefits
• Continued Education
• PTO Plan
• Retirement Planning
• Life Insurance
• Employee discounts

Position Summary: The Compliance Analyst’s primary job responsibilities include conducting and responding to internal and external audits, conducting compliance investigations, and responding to medical record requests. In addition, the Compliance Analyst will support all aspects of the Compliance Program on an as needed basis.

Schedule: Mon-Fri 8-5 / 1 day in Frisco office (Tuesdays) - all other days from home

Essential Duties:

• Handles external audits (e.g. Medicaid) including gathering and preparing the documentation and handling any necessary appeal. This includes being the point of contact with the external party as needed
• Develops and conducts internal audits based on the company’s identified compliance risks
• Drafts, monitors and reports timely completion of corrective action plans
• Performs research of regulations and requirements from multiple sources including federal and state laws
• Creates and maintains databases to demonstrate an effective compliance program
• Conducts, documents, and reports on compliance related investigations
• Receives and responds timely to medical record requests from external parties (including clients/patients)
• Develops and maintains standardized tools for documenting and reporting compliance activity throughout the enterprise
• Develops and produces written communications, emails, training materials, policies, standard operating procedures and guidance documents, with the ability to communicate information in a manner easily understood by various levels of individuals throughout the organization
• Perform special projects and assignments as requested in an accurate, timely and professional manner
• Maintains a high degree of confidentiality at all times due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, state, federal, HIPAA and privacy regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Other duties as assigned

Performance Responsibilities:

• Maintains positive internal and external customer service relationships
• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in continuous quality improvement
• Represents the organization professionally at all times

Position Requirements & Competencies:

• Bachelor’s degree in Health Care, Health Care Administration, Public Health, Public Administration, Public Policy, or other related field and/or a combination of relevant work experience
• Reimbursement knowledge preferred
• 2+ years of experience in health care compliance, in a provider or payer setting preferred
• Working knowledge of compliance –related issues such as Fraud, Waste, and Abuse and Anti-kickback regulations
• Ability to work independently
• Excellent verbal and written communications skills
• Ability to effectively analyze, interpret, apply and communicate policies, procedures and regulations
• Ability to operate PC-based software programs including proficiency in Word, Excel, and PowerPoint

To apply via text, text 5185 to 334-518-4376

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