Our client, a world re-owned cancer treatment and research center is seeking a Compliance Analyst.
This is a long-term temp position through February 2025
The work schedule is Monday – Friday, 9am – 5pm.
This is 100% REMOTE.
The pay rate is 22.00 per hour.
Job description:
The Revenue Cycle Compliance Analyst will work with the Senior Compliance Analyst to ensure compliance with all Government, Third Party Payer regulations and internal policies throughout the revenue cycle process. Analyzes billing processes and prepares training guidelines for use by operational managers. Maintains the Charge Description Master and participates in CDM audits performed by outside consultants. Responsible for special projects involving data management.
Demonstrates compliance with regulatory requirements, and mitigates financial risks for the organization by coordinating responses to RAC (Recovery Audit Contractor) audits. Maintains knowledge of healthcare regulations and assists in the maintenance of Revenue Cycle compliance documentation files.
Job Responsibilities
Job Responsibility Title Job Responsibility Detail % TIME
Project Implementation and Organization Responsibility Detail:
Initiates analysis of issues and ensures timely and accurate completion of assignments through effective planning and monitoring of progress against the project plan and/or instructions from manager.
Performance Expectations:
Prioritizes tasks based on instructions from Senior Analyst/Manager
Works with minimum guidance, monitoring, preparing and submitting status reports to manager on a routine basis
Determines approach, schedule and method for handling assigned projects
Organizes files and ensures that data are readily available to the Management staff as needed.
Complies with all departmental and institutional privacy and billing policies and procedures
Notifies supervisor, manager or compliance manager about possible non-compliance.
30%
Data Management Responsibility Detail:
Researches, organizes, tabulates and analyzes data from a variety of sources in order to ensure comprehensive and effective audits.
Performance Expectations:
Evaluates third party bulletins to validate patient accounting systems compliance are the same
Seeks input from appropriate ancillary department to identify aspects of negotiations requiring interpretation in order to effect appropriate system changes
Writes and runs reports from Cognos
Develops and maintains spreadsheets and databases to capture and record data results
Enters all changes/updates and deletions related to the hospital charge master
Performs quality assurance checks on data including daily reports related to updates within the CDM
Assists in maintaining complete and organized records on all audits, compliance write-up’s and CDM logs
Assists in database maintenance created to track and report billing issues and their resolution.
20%
Auditing Responsibility Detail:
Conducts ad hoc and scheduled audits as directed by manager within established timeframes.
Performance Expectations:
Participates in the development and creation of reports needed to identify cases for audits
Assists in retrieving and organizing all documents required for audits
Performs routine audits of claim files to validate appropriateness of rejected claims based upon claim validation
Provides timely feedback to manager on audits with recommendations for change and process improvement
Develops volume and trend analysis and works with departmental staff to recommend corrective action to management
Accesses billing claims data to identify and determine reasons resulting in rejected or non-compliant claim scenarios
De-identifies documents sent outside MSKCC in order to protect patient privacy in compliance with federal and state guidelines, assigning non-patient specific identifiers as appropriate.
20%
Information Management Responsibility Detail:
Maintains detailed policies and procedures to support Departmental adherence to billing compliance policies.
Performance Expectations:
Maintains knowledge of third party billing regulatory requirements and the knowledge of insurance reimbursement using resources such as Medicare Bulletins, CMS and government web sites
Participates in Department/Center and outside meetings to remain current on relevant regulations
Identifies need for updates to billing policies as a result of regulatory or departmental changes and updates accordingly
Assists in the preparation of e-mails and documentation regarding billing policy updates
30%
