COMPLIANCE ANALYST – WORK FROM HOME
The Compliance Analyst is responsible for assisting the Compliance Manager and/or Compliance Director with the tracking and resolution of compliance-related issues within the SSC.
DUTIES (included but not limited to) under the direction of the Compliance Manager:
Assists department management with completion of periodic reviews, audits and other requirements outlined in Company policies and Standards.
Performs research and analysis on Corporate and federal payer rules, regulations and transmittals to address operational relevance and impact.
Assists department management with the tracking and resolution of compliance issues which affect operations. Assists operational department managers with resolving compliance or regulatory concerns.
Logs privacy-related issues into the Privacy Log and ensures all information is present for appropriate reporting.
Provides analysis of proposed and final changes to Medicare regulations which affect SSC operations and provides education to Compliance Department leadership when necessary.
Tracks and provides timely follow-up to facilities on audit and re-bill projects related to potential governmental overpayment issues.
Assists with the processing of Risk Management/Quality of Care incidents in accordance with client protocols.
Logs details of potential Identity Theft Red Flags cases including investigation findings.
Tracks compliance education completion to ensure individuals do not miss completion deadlines.
Compile documentation required for internal and external audits at the SSC/HSC and facilities. This can include the provision of UBs, detailed bills, EOBs/ remits, MSP Questionnaires, and Financial screen prints, other relevant correspondence and the response documents.
Audits include but are not limited to: internal coding and OPPS audits, external Medicaid and MSP audits, OCR requests and State/Federal audits.
Monitors governmental overpayments for timely rebilling.
Provides superb customer service to all clients.
Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement.
Other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES:
Communication – communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
Customer orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Interpersonal skills – able to work effectively with other employees, patients and external parties
PC skills – demonstrates proficiency in Microsoft Office applications and others as required
Policies & Procedures – demonstrates knowledge and understanding of organizational policies, procedures and systems
Basic skills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.
High school diploma or GED required.
Associates degree preferred
One year of related experience required.
Medical & Health , Medical Billing , Medical Coding