Regulatory Compliance Specialist-Medicare Analyst

3 weeks ago

Houston, United States Houston Methodist Full time

***Medicare compliance experience is preferred Note: Office for this position is located at our Continuing Care Hospital:

701 S. Fry Rd. Katy, TX 77450

. (Hybrid position) At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central Business Office (CBO) leadership, to assess, track, monitor, document progress and status of management action plans and maintain completion of compliance recommendations set forth by audits from Center for Medicare/Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston Methodist Internal Audit compliance reviews. This position audits sources include but are not limited to CMS, OIG, RACs, MACs, ADRs, TPEs, CERTs, Z/UPICS, along with Houston Methodist Internal Audit recommendations. Responsibilities for this position included working with the applicable staff from Corporate Finance, Revenue Cycle, Business Practice, Ancillary Service Areas, CBO Staff, and/or Internal Audit to document closure of action items related to defined audit events as well as the accountability of ensuring completion with corrected claims, and/or data extraction in preparation of audits.

PEOPLE ESSENTIAL FUNCTIONS Collaborates and effectively communicates with a wide variety of disciplines with the organization and revenue cycle to assist in evaluating, monitoring, documenting, and trending completion of recommendations or findings. Provides clear and concise communication of trending and findings to CBO leadership. Maintains a strong sensitivity to customer needs at the forefront of CMS Audit or internal regulatory projects/efforts/needs by ensuring timely and complete compliance with customer requests. Consistently executes in appropriately balanced behavior that support I CARE values. Communicates in a time efficient and effective manner.

SERVICE ESSENTIAL FUNCTIONS Responsible for coordination and provision of ongoing support and assistance to CBO leadership regarding completion of audit findings and recommendations. Assists as needed in initial and/or subsequent data captures and requests for regulatory or internal audits and ensures to transmit with appropriate HIPAA standards for PHI. Provides subsequent follow up reviews of previously identified issues and/or requests that result from audit events and ensures the action item is complete. Acts as a liaison between the customer and the CBO team to ensure timely compliance with and completion of audit or data requests.

QUALITY/SAFETY ESSENTIAL FUNCTIONS Assists management in developing internal quality measures to evaluate, improve and sustain performance improvement initiatives while serving as a resource for these efforts. This can include but is not limited to assisting in re-educating staff as needed, updating policies and procedures relative to audit findings and recommendations as indicated by management. Responsible for ensuring that non-conformities identified during the audit process have complete resolution by providing follow up activities and documentation of the same. Provides technical assistance to management and functions as subject matter expert for compliant billing for government payers.

FINANCE ESSENTIAL FUNCTIONS Assists management as needed to implement audit findings to reduce compliance errors, avoidable denials, recoupments, and losses. Assists management in finalizing quarterly credit balance report to Medicare. Practices good time management, good assessment in professional decision-making, and reporting skills which includes managing self to ensure project deliverables are met.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS Maintains current knowledge of applicable state and federal regulations, CMS regulation, and billing requirements Remains current with regulatory changes by utilizing available educational tools and by reviewing professional journals, as well as communicating changes or newly developed standards, requirements, and clauses to appropriate staff, departments and leadership, as indicated. Effectively uses technology tools to execute job functions and accomplish duties which includes Microsoft Office Suite, Change Healthcare products, Epic, etc. Continues personal development to ensure balanced execution of functions technically and behaviorally.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) Some college preferred

WORK EXPERIENCE Five years' experience in revenue cycle in a hospital setting Demonstrated application of government billing and collections Government billing and collections experience in a hospital setting Epic experience in HB preferred

#J-18808-Ljbffr

  • Regulatory Compliance Specialist III

    4 weeks ago

    Houston, United States The Williams Companies Inc Full time

    As a Regulatory Compliance Specialist III, you will represent Williams in dealings with federal and state agencies. This role is responsible for interpreting regulations, working with applicable agencies and coordinating with management to ensure ove Compliance Specialist, Regulatory, Compliance, Specialist, Microsoft, Benefits, Healthcare

  • Regulatory Compliance Specialist

    2 weeks ago

    Houston, United States Global Healing Center Incorporated Full time

    Who We Are: Global Healing Center is a leading manufacturer, distributor, and retailer of healthy living products, specializing in cleansing and detoxification. Our mission: create and market the best products possible, help as many people as we can through education, and provide customers with solutions to live a healthy lifestyle. Check us out at...

  • Regulatory Compliance Specialist

    2 days ago

    Houston, United States Global Healing Full time

    Job Description Job Description Who We Are: Global Healing Center is a leading manufacturer, distributor, and retailer of healthy living products, specializing in cleansing and detoxification. Our mission: create and market the best products possible, help as many people as we can through education, and provide customers with solutions to live a healthy...

  • Regulatory Compliance Specialist

    1 month ago

    Houston, United States Global Healing Full time

    Job DescriptionJob DescriptionWho We Are:Global Healing Center is a leading manufacturer, distributor, and retailer of healthy living products, specializing in cleansing and detoxification. Our mission: create and market the best products possible, help as many people as we can through education, and provide customers with solutions to live a healthy...

  • Regulatory Compliance Specialist

    4 weeks ago

    Houston, United States Global Healing Full time

    Who We Are: Global Healing Center is a leading manufacturer, distributor, and retailer of healthy living products, specializing in cleansing and detoxification. Our mission: create and market the best products possible, help as many people as we can through education, and provide customers with solutions to live a healthy lifestyle. Check us out at...

  • Compliance Analyst

    6 days ago

    Houston, United States Westinghouse Electric Company Full time

    Westinghouse is seeking a TSA Compliance Analyst for a 2-3 month project with our energy client in Houston, Texas. Job DescriptionThe position oversees the design and development of programs, processes, and procedures necessary to assure compliance with TSA. Monitors various regulatory statutes and protocols, coordinates and implements new initiatives...

  • Regulatory Specialist

    3 weeks ago

    Houston, United States SageTech Resources Full time

    Our client is seeking an experienced Regulatory Specialist who will encompass overseeing regulatory and technical matters pertinent to offshore shallow-water oil and gas production endeavors. This position involves meticulous document preparation and addressing regulatory challenges. Key Responsibilities: Preparing regulatory documentation essential for...

  • Pharmacy Compliance Analyst

    3 weeks ago

    Houston, United States Onco360 Full time

    Compliance Analyst needed in the Houston metro area! Join our growing organization! We need this role to be within driving distance to our pharmacy location. Onco360 has an immediate need for a Compliance Analyst. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients,...

  • Regulatory Specialist

    3 weeks ago

    Houston, United States SageTech Resources Full time

    Our client is seeking an experienced Regulatory Specialist who will encompass overseeing regulatory and technical matters pertinent to offshore shallow-water oil and gas production endeavors. This position involves meticulous document preparation and addressing regulatory challenges.Key Responsibilities:Preparing regulatory documentation essential for...

  • Regulatory Specialist

    3 weeks ago

    Houston, United States SageTech Resources Full time

    Our client is seeking an experienced Regulatory Specialist who will encompass overseeing regulatory and technical matters pertinent to offshore shallow-water oil and gas production endeavors. This position involves meticulous document preparation and addressing regulatory challenges.Key Responsibilities:Preparing regulatory documentation essential for...

  • S&E Regulatory Sr. Analyst

    6 days ago

    Houston, United States Repsol SA Full time

    S&E Regulatory Sr. Analyst page is loaded S&E Regulatory Sr. Analyst Solicitar locations Houston time type Tiempo completo posted on Publicado hace 6 días job requisition id 71906 At Repsol, we are committed to equality and do not request personal information. We believe that diversity contributes to innovative ideas and provides added value that enables us...

  • Regulatory Compliance Manager

    4 weeks ago

    Houston, United States HTH Communications, LLC. Full time

    If you love fast-paced ever changing world challenges, HTH is the right place for you to grow your career. Headquartered in Houston, Texas. HTH Communications is one of the fastest growing companies in the wireless industry. With roots in the refurbishment and distribution of mobile devices, over the past decade HTH has grown into a full-service logistics...

  • Regulatory Compliance Manager

    4 weeks ago

    Houston, United States HTH Communications, LLC. Full time

    If you love fast-paced ever changing world challenges, HTH is the right place for you to grow your career. Headquartered in Houston, Texas. HTH Communications is one of the fastest growing companies in the wireless industry. With roots in the refurbishment and distribution of mobile devices, over the past decade HTH has grown into a full-service logistics...

  • Customs Compliance Specialist

    3 days ago

    Houston, United States NOV Inc. Full time

    **Job Requisition: U.S. Customs Compliance Specialist** **Key Responsibilities**: - **Policy & Procedure Implementation**:Implement NOV’s customs compliance policies & procedures across all relevant departments, ensuring adherence to regulations and minimizing the risk of non-compliance. - **Customs Entry Processing**:Oversee the timely and accurate...

  • Analyst - EHS Air Compliance

    2 weeks ago

    Houston, United States Coterra Energy Full time

    ABOUT COTERRA ENERGY Coterra Energy Inc. was formed in October 2021 as the result of a merger between Cabot Oil & Gas Corporation and Cimarex Energy. By merging, the two legacy companies have created one entity full of talented people with decades of experience in the energy industry. Our team is passionate about delivering reliable energy to all and...

  • Sr Business Practices Analyst

    1 day ago

    Houston, United States Houston Methodist Full time

    NOTE: After department orientation, this position will have an opportunity to work hybrid At Houston Methodist, the Senior Business Practices Analyst is responsible for managing Business Practices programs. With limited supervision, serves as lead in the development of assigned components of the Business Practices Program. Provides advice and counsel on...

  • Trade Compliance Analyst

    2 weeks ago

    Houston, United States Chevron Full time

    Collaborating with compliance colleagues to establish and help deploy appropriate compliance procedures. Serving as a point of contact for supported business unit personnel needing guidance on trade compliance requirements. Supporting supervisor in a Compliance Analyst, Trade, Compliance, Analyst, Business Partner, Leadership, Business Services

  • Compliance Tax Credit Specialist

    5 days ago

    Houston, United States Indio Management Full time

    **Allow us to INTRODUCE ourselves**: Headquartered in Dallas, Indio is proud to call Texas home. With deep roots in the community, we approach each day with an outward focus on how we can help others. We believe maintaining a lifestyle for our residents is essential, and we focus on exceptional service, effective communication, and rapid responsiveness....

  • Compliance Specialist 503b

    1 month ago

    Houston, United States Empower Pharmacy Full time

    Position Summary: Elevate the standards of pharmaceutical compliance and ignite your career as a 503B Compliance Specialist at Empower. In this role, you will be at the forefront of overseeing and enforcing adherence to critical regulatory frameworks, including those governed by the DEA, FDA and State Boards of Pharmacy. Your meticulous attention to detail...

  • Compliance | PSA Compliance Specialist

    1 day ago

    Houston, United States Catholic Charities of the Archdiocese Full time

    Job DetailsJob Location Central - Houston, TX Education Level 4 Year Degree Travel Percentage Negligible Job Shift Day Description Catholic Charities is looking for the right people; people who wish to serve their community as a part of a family friendly organization doing good within the Houston-Galveston area. We attract and retain the best talent by...