This listing was posted on ApplicantPro.
Senior Compliance Analyst
Location:
Remote, OR
Description:
Senior Compliance Analyst Job Description Join us in powering the future of healthcare cost containment. Exponent Health (formerly HRGi Holdings, Inc.) has an exciting opportunity for a Senior Compliance Analyst in our Operations / Products, Policy, Strategy line of business. Our team of brilliant professionals are continuously expanding the boundaries of the healthcare industry through innovations that intersect data and technology and amplifies human intelligence to result in better outcomes. We need people like you to join in our commitment to drive pure exponential value for our clients and partners. Are you up for the challenge? Y ou'll work in a highly collaborative and creative team of talented professionals to evolve our business. Use creativity and innovation to monitor ongoing state and federal in a quickly evolving healthcare landscape. In this role, you will support the medical cost containment line of business by: Delivering and Executing (75%) - Collects and documents requirements from state and federal agencies; Participates in project planning and make recommendations on prevailing information; Maintains information accessible to stakeholders for ongoing awareness on compliance requirements necessary for administration of medical cost containment solutions; Generates appropriate whitepapers; Conducts research on competitors and industry challenges as needed; Follows best practices established by the organization and participates in improvement conversations; Consistently helps the team achieve results, even under tough circumstances. Learning and Growing (20%) - Actively learns business process flows and business model. Learns through successful and failed experiment when tackling new problems; Actively seeks ways to grow and be challenged using both formal and informal operation channels. Planning and Aligning (5%) - Builds partnerships and works collaboratively with others to meet shared objectives; Collaborates with other team members in agile processes; Relates openly and comfortably with diverse groups of people. This role does not require travel, but there may be occasions to travel for team planning/development with advanced notice. What you bring To be successful in this role you'll need: Good judgment, initiative, and discretion in confidential or sensitive matters Self-starter with the ability to independently work urgently approaching deadlines and in a team Creative thinking and effective risk mitigation abilities with strong decision-making skills Strong analytical ability Strong knowledge of Medicaid, Medicare, group health, contracts, letters of agreement, and/or legal/regulatory interpretation Certified Professional Coder or Certified Professional Biller or Certified Fraud Examiner designation encouraged Knowledge of economic models or statistics encouraged Strong knowledge of Medicare fee schedule development and gaps recommended Responsibilities Core area of responsibilities center around assisting the medical cost containment product owner in the areas listed below. Partner with other business units to ensure compliance with implementing, adopting, or expanding on the rules and/or regulations, including but not limited to policies, procedures, and contracts Provide consultation internally or externally where appropriate Monitor regulatory changes, legislative efforts, and/or industry trends with recommendations for company direction for existing or future products, including but not limited to Managed Medicaid, State Balance Billing Laws, and the federal No Surprises Act Provide internal training where required for compliance Assist in the development of compliance processes and procedures Assist in communications with government regulatory bodies where applicable Conduct compliance audits Assist in the development of compliant products for clients and/or perform compliance-related audits Other duties as assigned or requested Required Expertise Current or former Certified Professional Compliance Officer designation through the AAPC or similar credential from a similar organization (If former certification, willing to renew within 24 months of hire); or bachelor's degree or above. Strong computer skills and experience with relevant software Excellent communication and presentation Strong critical thinking, analytical, and problem-solving Good interpersonal and organizational Preferred Skills 5+ Years with current or former healthcare fraud, compliance, and/or legal experience. 3+ Years working with various medical reimbursement methodologies. 3+ Years understanding medical coding and/or billing patterns and/or practices. Familiar with the No Surprises Act, Balance Billing Laws, HIPAA, and similar healthcare laws. Strong written and oral communication skills. Advanced knowledge of Excel, PowerPoint, and Word. What it's like to work with us Exponent Health has been challenging the industry status quo for over 30 years, leading with ground- breaking innovation in a wide variety of healthcare cost-management solutions. Embracing the latest opportunities that technology can offer within a rapidly evolving industry, we provide exceptional service, technology, and product innovation to meet greater challenges in healthcare cost management. We have a distributed workforce so you can work from anywhere in the continental United States. Because of our distributed nature, we have cultivated a connected culture that includes town halls, one-on-ones with executive leadership, educational forums, and even social clubs. We offer comprehensive benefits package which includes the following: Medical, dental, and vision insurance Short term disability and long-term disability Life insurance and AD&D Supplemental life insurance (Employee/Spouse/Child) Healthcare and dependent care Flexible Spending Accounts Healthcare Savings Account 401(k) Savings and Investment Plan with company match Paid time off
Company:
Exponent Health
Posted:
December 26 2023 on ApplicantPro
Visit Our Partner Website
This listing was posted on another website. Click here to open: Go to ApplicantPro
Important Safety Tips
- Always meet the employer in person.
- Avoid sharing sensitive personal and financial information.
- Avoid employment offers that require a deposit or investment.
To learn more, visit the Safety Center or click here to report this listing.
More About this Listing: Senior Compliance Analyst
Senior Compliance Analyst is a Jobs Analyst Job at Exponent Health located in Remote OR. Find other listings like Senior Compliance Analyst by searching Oodle for Jobs Analyst Jobs.
Senior Compliance Analyst is a Jobs Analyst Job at Exponent Health located in Remote OR. Find other listings like Senior Compliance Analyst by searching Oodle for Jobs Analyst Jobs.