At this company, we find that our best leaders are those who create an inspiring vision for the future and empower their team to achieve success. They have always enjoyed tackling difficult problems and believe that the best way to solve them is through collaborative, team efforts. They take ownership of results and instill accountability in those they lead. They are driven, strong communicators, relationship builders, and find real fulfillment in challenging work.
Sound like you? Then you might be a great fit for Compliance Senior Analyst, Revenue Operations with this company.
Here is what you can expect when you join our Village:
- A "community first, company second" culture based on Core Values that really matter;
- Clinical outcomes consistently ranked above the national average;
- Award-winning education and training across multiple career paths to help you reach your potential;
- Performance-based rewards based on stellar individual and team contributions;
- A comprehensive benefits package designed to enhance your health, your financial well-being and your future; and
- Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation.
This position reports to the Compliance Manager of Revenue Operations and will apply their experience with investigations, audits, and/or consulting projects to identify and evaluate compliance and regulatory risks associated with potential non-compliance with Company policies, procedures, and practices. Generally, this position assists in the execution of the day-to-day compliance program for our Revenue Operations department, including Payor Setup, Credits and other supporting teams. The position, amongst other responsibilities outlined below, will investigate potential compliance issues linked to billing and collections activities.
The job responsibilities of the Healthcare Compliance Senior Analyst position include, but are not limited to, the following, with a goal of mitigating risk related to the False Claims Act and other state and federal regulations:
- Investigate potential compliance issues linked to billing and collections activities;
- Conduct billing and collection system investigations and audits including performing risk assessment, scoping investigation/audit, developing investigation/audit work plans, performing investigation/audit procedures, documenting work, reporting findings, and developing and implementing appropriate remediation;
- Perform proactive process and control assessments of policies, procedures and billing and collections systems and functions;
- Define and understand potential compliance issues, collect and analyze large amounts of data, perform research, identify root causes of potential issues, and evaluate risk to make timely and appropriate decisions;
- Utilize Excel, Access, and other tools to perform qualitative and quantitative analyses on large amounts of clinical and billing data and develop presentations to communicate the results of such analyses to compliance and operations management;
- Conduct multiple projects concurrently while managing timelines with their manager and internal customers and assist their manager with projects related to the overall compliance audit and monitoring Programs;
- Draft written presentations to compliance and operations management to inform decision making; and
- No direct reports.
- Bachelor’s degree required; JD/CPA/CIA/MBA or other relevant advanced degree or certification preferred;
- Certificate in Healthcare Compliance preferred;
- Minimum of 3 years’ experience as an investigative, audit, compliance, or legal professional responsible for compliance investigations, external/internal audits, and consulting projects (e.g., process and control assessments);
- Required experience working with Medicare Fee for Service claims and respective electronic health record and billing IT systems;
- Preferred experience working with healthcare billing, claim coding or healthcare revenue operations;
- Preferred experience working for audit firms, or a healthcare company;
- Preferred experience in healthcare industry dealing with federal healthcare program laws, specifically the False Claims Act;
- Preferred experience working with Medicare Fee for Service regulations including CMS Conditions for Coverage (CfC), Conditions for Participation (CfP), and other CMS Manuals;
- Strong organizational and project management skills with demonstrated attention to detail;
- Advanced experience with Excel spreadsheets and data analysis involving a large volume of data (e.g., Pivot Table, Vlookup, etc.);
- Experience in positively and successfully managing relationships with a high energy and diverse group of internal customers across organizational lines;
- A passion for relationship building and partnering with professionals in Legal, Revenue Operations, and Compliance to build strong processes and effectively problem solve.
- A thoughtful, articulate and effective critical thinker and communicator who can distill and articulate the important aspects of any issue;
- Superior written and verbal communication skills (including presentations) and the ability to drive execution in a team environment;
- Must be self-motivated, team player with proven ability to identify issues, manage priorities, and deliver on commitments in a fast paced environment; and
- Hands on, efficient and proven ability to “Get Stuff Done” with a bias for action and a strong sense of ownership.
- Limited travel required: up to 10%