Senior Compliance Analyst

1 week ago

Denver, Colorado, United States Lorven Technologies Full time
Senior Analyst Job Description

Lorven Technologies is seeking a highly skilled Senior Analyst to join our team. As a Senior Analyst, you will play a critical role in mitigating risk related to the False Claims Act and other state and federal regulations.

Key Responsibilities:
  • Investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems.
  • Conduct IT system investigations and audits, including risk assessments, scoping investigations/audits, and developing investigation/audit work plans.
  • Perform proactive process and control assessments of policies, procedures, and clinical IT systems.
  • Define and understand potential compliance issues, collect and analyze large amounts of data, and perform research to identify root causes of potential issues.
  • Utilize Excel, Access, and other tools to perform qualitative and quantitative analyses on large amounts of clinical and billing data.
  • Develop presentations to communicate the results of such analyses to compliance and operations management.
  • Conduct multiple projects concurrently while managing timelines with your manager and internal customers.
Qualifications:
  • Bachelor's degree required; JD/CPA/CIA/MBA or other relevant advanced degree or certification a plus.
  • Certificate in Healthcare Compliance preferred.
  • Minimum of 3 years' experience as an investigative, audit, compliance, or legal professional responsible for compliance investigations, external/internal audits, and consulting projects.
  • Preferred experience working with Medicare Fee for Service claims and respective electronic health record and billing IT systems.
  • Preferred experience working for Big 4 or mid-sized audit firms, other consulting firms, or a healthcare company.
  • Preferred experience in healthcare industry dealing with federal healthcare program laws, specifically the False Claims Act.
  • Preferred experience working with Medicare Fee for Service regulations including CMS Conditions for Coverage (CfC), Conditions for Participation (CfP), and other CMS Manuals.
  • Strong organizational and project management skills with demonstrated attention to detail.
  • Experience in positively and successfully managing relationships with a high energy and diverse group of internal customers across organizational lines.
  • Advanced technology skills including Excel, PowerPoint, and Access.
  • A thoughtful, articulate, and effective critical thinker and communicator.
  • Superior written and verbal communication skills (including presentations) and the ability to drive execution in a team environment.
  • Must be self-motivated, team player with proven ability to identify issues, manage priorities, and deliver on commitments in a fast-paced environment.

Limited travel required: up to 10%.

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