Regulatory Compliance Analyst

2 weeks ago


West Burlington, Iowa, United States Great River Health Full time

Minimum Hiring Wage:
From $52,291.20 a year

Job Details:

Scheduled Hours:
Monday - Friday, days

Occasional travel required

Job Overview:


The Compliance Analyst collaborates with healthcare providers and administrative staff to enhance the quality, adherence, completeness, and precision of medical documentation for both facility and professional interactions.

Engages in the review, development, and modification of processes, systems, and protocols to ensure alignment with billing requirements and compliance standards.

Conducts coding audits and related initiatives to uphold professional and facility coding compliance. Performs routine audits to verify coding accuracy and the sufficiency of accompanying provider documentation to meet compliance standards. Completes audit tasks and other projects as part of ethics and compliance work plans. Provides education to physicians and staff on appropriate coding and documentation standards and regulations.

Exhibits a comprehensive understanding of intricate coding, reimbursement, and auditing principles as they pertain to hospital, physician practice, clinic, and hospital-based clinic environments.

Maintains communication with department leadership, physicians, and staff regarding complex coding and auditing matters and current coding regulations.


Prepares detailed reports of audit findings and meets with providers to deliver education and training on compliance with documentation and coding standards.

Investigates, analyzes, and addresses inquiries related to coding concerns and associated issues. Engages extensively with physicians and other patient care providers concerning documentation and coding policies, procedures, and regulations.


Trains and provides technical support to medical providers and coding leadership on compliance, documentation, regulatory provisions, and third-party requirements.

Assists with comprehensive chart reviews, compliance investigations, and risk assessments (outliers, benchmarks, etc.). Participates in coding conferences, workshops, and in-house meetings to stay updated on coding information and regulatory changes. Collaborates with Compliance and Revenue Cycle leadership to identify documentation opportunities, educational priorities, and ensure adherence to regulatory standards.

Qualifications:
Graduate of Health Information Technology program or related field

Three to Five years' experience in billing/coding utilizing ICD -9/ICD-10 and CPT codes in a medical clinic, physician's office, or health system

Certified coder with one of the following credentials: RHIA, RHIT, CPC, COC

Certified Professional Medical Auditor (CPMA), Certified Healthcare Chart Auditor (CHCA) or equivalent certification required after two years of employment

Strong computer skills and knowledge

Good understanding of medical terminology

Knowledge of laws, government regulations, CMS, and agency guidelines

Benefits:
We are pleased to offer a competitive compensation and benefits package for eligible positions, which includes:

Competitive base salary

Matching retirement plans

Health, Dental, and Vision insurance

Health Savings and Flexible Spending Accounts

Employee discounts including car rental and cell-phone plans

Employer-paid Long-Term Disability, Life, and AD&D insurance

Paid time off (PTO)

Education Assistance Program

Employee Assistance Program

Employee Referral Bonus Program

Discounted cafeteria meals

Paid Parental Leave

Employee Service Recognition program

Voluntary plans available:
Life, AD&D, Short-Term Disability, Critical Illness, Accident, Insurance, and Hospital Indemnity

Great River Health and its affiliates are Equal Opportunity employers.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

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