Healthcare Compliance and Billing Analyst

2 weeks ago

Cleveland, Ohio, United States Cleveland Clinic Full time

Join the esteemed Cleveland Clinic family, where you will collaborate with dedicated professionals to deliver exceptional patient-centered healthcare.

At Cleveland Clinic, you will engage with committed and passionate team members, receive continuous support and recognition, and cultivate a fulfilling career within one of the most respected healthcare institutions globally.

As a Healthcare Compliance and Billing Analyst, you will play a vital role in supporting the Office of Corporate Compliance by overseeing and managing the Compliance Program of the Cleveland Clinic Health System (CCHS).

In this position, you will have the distinct opportunity to identify, prevent, detect, and address instances of non-compliance by ensuring that reported issues are managed promptly, thoroughly, and appropriately by designated investigators.

Your responsibilities will include, but are not limited to, addressing reports of unauthorized uses and disclosures of patient information, as well as allegations of workplace discrimination, harassment, and other violations.

The Compliance Officer at Cleveland Clinic reports directly to the Audit Committee of the Board of Directors, reflecting the unwavering support of senior management for the critical work conducted by the Compliance office. This structure facilitates the escalation of issues to the Board when necessary to ensure proper resolution of non-compliance.


The ideal candidate will possess the following qualities:

- Proficiency in researching, understanding, and applying relevant laws and regulations in healthcare, particularly HIPAA Privacy, Security and Breach Notification Rules, Fraud Waste and Abuse laws (e.g., Stark, Anti-Kickback, Civil Monetary Penalties), and EMTALA.

- Strong ability to build effective working relationships across all organizational levels and communicate clearly and effectively, both verbally and in writing.

- Capacity to maintain objectivity and strict confidentiality while performing job duties.

- Skills to manage and prioritize multiple investigations simultaneously while meeting established deadlines with minimal supervision.

- Proven ability to collaborate effectively with others and foster trust within a team.

This position offers a rewarding opportunity with growth-oriented projects, mentorship, support, and resources. You will gain valuable exposure to both institutional and departmental leadership, with numerous opportunities for career advancement.

At Cleveland Clinic, we prioritize what matters most. We treat our caregivers as family and continually seek ways to support you.


Here, you will find:

- Resources for professional development and growth.

- A fulfilling career path for everyone.

- Comprehensive benefits that support your health, well-being, and future.

When you become part of Cleveland Clinic, you will join a supportive family of caregivers united by shared values and a common purpose to fulfill our commitment to being the best place for care and the best workplace in healthcare.


Key Responsibilities:
  • Integrate system-wide compliance initiatives and assist in resolving issues through the development of corrective action plans.
  • Support the Director in identifying and analyzing risk areas.
  • Coordinate responses to monitoring and audit activities.
  • Disseminate materials containing relevant compliance-related information from resources such as DHHS, CMMS, OCR, and OIG.
  • Perform other duties as assigned.

Education:

Bachelor's degree in a related field.


Certifications:

Preferred certification in healthcare compliance.

Certification in Medical Coding.


Complexity of Work:

This role requires critical thinking skills, decisive judgment, and the ability to work independently.

Must be capable of functioning in a high-pressure environment and taking appropriate actions.


Work Experience:

Preferred: 3 years of HIM Coding/Billing experience.

Required: 3 years of recent experience in healthcare compliance, auditing, billing, coding, reimbursement, and/or information management.


Offset:

High School Diploma/GED or equivalent with 7 years of relevant experience.


Personal Protective Equipment:

Adhere to standard precautions using personal protective equipment as required.


Pay Range:

Minimum hourly: $30.41

Maximum hourly: $46.38

The displayed pay range reflects the anticipated range for new hires. Actual compensation will be determined based on factors such as work history, experience, skill set, and education. This does not include the value of Cleveland Clinic's benefits package, which encompasses healthcare, dental, vision, and retirement benefits.

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