Senior Compliance Analyst

  • Requisition ID: 177475
  • Department: 100603 Corporate Compliance
  • Schedule: Full Time - Eligible for Benefits
  • Shift: Day
  • Category: Professionals

Position Purpose

Contributes to the fulfillment of the Renown Health purpose by promoting a culture of ethical and compliant behaviors and practices accomplished through planning, coordinating, implementing and maintaining a system-wide compliance program as part of the Renown Health Corporate Compliance Program, inclusive of the Hometown Health Compliance Program. This compliance program provides education, guidance, audits and monitoring of billing and health plan activity for Renown Health and delegated entities. Serves as the primary Renown Health resource regarding issues related to billing or health plan compliance, which may include appropriate Renown business practices for patient registration, documentation, coding, and claim submission or appropriate Hometown Health business practices for member enrollment, claim adjudication, provider network standards, marketing, call center operations, utilization management. In collaboration with the Internal Audit Department also supports projects related to compliance risk assessments, compliance audit and self-monitoring programs, and compliance audits conducted by independent outside firms.

 

 

 

Nature and Scope

This position is responsible for identifying and assessing areas of compliance risk; assisting with the development and implementation of compliance training and education programs; serving as a point of contact for Renown Health or Hometown Health employees regarding potential compliance concerns and questions; researching federal and state regulations; monitoring and communicating regulatory changes that impact Renown Health and delegated entities; and supporting compliance leadership in timely detection, response, investigation, analysis and applicable corrective action pertaining to any compliance matter.

 

The Senior Compliance Professional may co-chair the various Compliance Committees.

 

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. The responsibilities of this position may include the performance of other duties.

 

This position does not provide patient care.

 

 

Disclaimer

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

 

 

 

Minimum Qualifications
Requirements - Required and/or Preferred

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English. A Bachelor's degree in Business Administration or related field is required; a Master’s in Healthcare or Business Administration is strongly preferred. Educational requirements may be waived if extensive working experience is demonstrated.

Experience:

Requires a minimum of eight years of health care billing or regulatory experience. Preference will be given to those applicants with experience in more than one setting (i.e. skilled nursing facilities, acute hospital, home health, physician office, health plan, etc.) and/or clinical experience.

License(s):

None

Certification(s):

Professional or Facility Coding Certification and CHC certification strongly preferred.

Computer / Typing:

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

 

 

Benefits

Renown Health exists to make a genuine difference in the health and well-being of the people and communities we serve. And it is through your passion that this mission is made real every day. The relationship with employees is the foundation for success as we proceed with our strategic direction. We strive to build upon this solid partnership by offering a comprehensive and competitive benefits package that meets the diverse needs of employees and their family members.

With my CAREER Rewards there's peace of mind in knowing that Renown Health is also fighting for the most important things in your life - family, finances and future. Navigate options and make sure you are getting the most value from your Nursing career with us.

  • Icon- Edu Assistance@1x

    Education Assistance

  • Icon - PTO@1x

    Paid Time Off

  • Icon - 401@1x

    401(k) Company Match

  • Icon - Flexible Env@1x

    Flexible Work Environment