Position Summary: As a Compliance Analyst I you will facilitate and administer compliance activities related to the operation of the CCS Medical Compliance Program. Auditing, investigations, tracking and analysis of compliance activities, ongoing Compliance and regulatory education and training, and being knowledgeable of current and ongoing changes to all applicable laws, rules, regulations, and CCS Medical protocol related to compliance activities.
What you’ll be doing...
- Researches, tracks and remains current on compliance, billing and other applicable laws, rules and regulations to determine their effect on CCS Medical operations, policies and procedures
- Provides regulatory support to all areas to assure regulatory compliance and appropriate regulatory planning
- Participates and facilitates in regulatory agency, internal, and vendor inspections and audits as needed
- Coordinates and participates in implementing programs, policies and practices to ensure that all operating units in the company are in full compliance with State and Federal Healthcare laws as well as payer guidelines
- Investigates and responds to internal and external customer compliance concerns in order to prevent, detect and correct improper or potentially improper activities
- Coordinate compliance and audit activities with Quality Assurance, as well as quality evaluations throughout the company and provide value added reporting of completed activities for Compliance and Operations Management.
- Analyzes and reports on compliance audit results, including Quality Assurance activities, and identifying areas of risk based on trends identified in the monthly internal audits, focused audits and/or external audits
- Consults and works with department management to make recommendations or modifications on business processes based on identified areas of risk
- Initiates and assists with implementing corrective and preventative actions as necessary to ensure compliance with standards and guidelines set forth in the CCS Medical Compliance Program and applicable local, State and Federal laws, rules and regulations
- Reviews, drafts and revises CCS Medical Compliance Program policies and procedures
- Coordinates and conducts educational and training activities as necessary covering the core standards of the CCS Medical Compliance Program and pertinent local, State and Federal laws, rules and regulations and private or commercial payor health care program requirements
- Prepares and maintains internal audit files
- Foster relationships with all employees throughout the Company
- Travel may be required
- Maintains a high degree of confidentiality at all times due to access to sensitive information
- Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
- Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements
- Abides by all regulations, policies, procedures and standards
- Exercises appropriate cost control measures
- Maintains positive internal and external customer service relationships
- Maintains open lines of communication
- Plans and organizes work effectively and ensures its completion
- Meets all productivity requirements
- Demonstrates team behavior and promotes a team-oriented environment
- Actively participates in Continuous Quality Improvement
- Represents the organization professionally at all times
What WE Bring to the Table:
We offer a wide variety of insurance benefits after 60 days of employment (medical, dental, vision, short and long-term disability, and life) with a large portion of premiums paid by the company, as well as paid time off within the first year. We also offer a 401(k) plan with a generous company match and vesting schedule, financial planning, competitive salary, and an EAP-Employee Assistance Plan.