Sr. Healthcare Compliance Analyst

Position Title: Sr. Compliance Analyst

Duration: PERM

Start Date: ASAP

Openings: 1

Perm Salary: $75,275- $112,902

MUST HAVE:

• 3+ Years of relevant healthcare compliance experience

• Recent experience with conflict of interest, exclusion monitoring, and billing/coding regulations

• HS Diploma or GED

PLUSSES:

• BA/BS in a relevant field

DAY TO DAY:

Insight Global is looking for a Sr. Compliance Analyst for one of the largest health systems in Colorado.

• The Sr. Compliance Analyst conducts reviews of healthcare risk areas pertaining to billing, coding, and other operational functions. Focuses may include areas identified by the Office of Inspector General (OIG), other applicable federal or state agencies, or by the industry at large.

• Exclusion Monitoring:

  • Regular Screening: Conduct regular checks against federal and state exclusion lists (e.g., OIG, SAM) to ensure that no excluded individuals or entities are employed or contracted by the hospital.

    Investigation: Investigate any potential matches found during exclusion screenings and take appropriate actions, such as notifying relevant departments and ensuring corrective measures are implemented.

• Conflict of Interest:

  • Policy Development: Assist in developing and updating conflict of interest policies to ensure they meet regulatory requirements and best practices.
  • Disclosure Management: Manage the process of collecting and reviewing conflict of interest disclosures from staff and physicians.
  • Training and Education: Provide training to employees on conflict of interest policies and procedures to ensure they understand their responsibilities.

• Billing and Coding Regulations:

  • Audit and Review: Conduct regular audits of billing and coding practices to ensure compliance with federal and state regulations, such as Medicare and Medicaid guidelines.
  • Error Correction: Identify and correct any billing or coding errors, and work with relevant departments to prevent future occurrences.
  • Regulatory Updates: Stay updated on changes in billing and coding regulations and ensure that the hospital’s practices are adjusted accordingly.