Compliance Analyst
- Medical, Dental and Vision Benefits
- Continued Education
- PTO Plan
- Retirement Planning
- Life Insurance
- Employee discounts
- Conducts, documents, and reports on compliance related investigations (primarily fraud and privacy).
- Responds to external investigations including gathering and preparing the documentation. 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.
- Performs research of regulations and requirements from multiple sources including federal and state laws.
- Creates and maintains databases to demonstrate an effective compliance program.
- 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.
- 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
- 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 preferred
- Investigation experience required
- Reimbursement knowledge preferred
- 2+ years of experience in health care compliance, in a provider or payer setting preferred
- Working knowledge of compliance and privacy related issues preferred
- 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
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