Location: Denver, CO
with Company policies, procedures, and practices.
Generally, this position assists in the execution of the day-to-day compliance program for our dialysis business unit, specifically the Information Technology (IT), Clinical Enterprise, and Revenue Operations departments.
The position, amongst other responsibilities outlined below, will investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems. The job responsibilities of the Senior Analyst, Compliance (Clinical Documentation and Billing Investigations) include, but are not limited to the following, with a goal of mitigating risk related to the False Claims Act and other state
and federal regulations: Investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems; Conduct IT system investigations and audits including performing risk backssments, scoping investigations/audits, developing investigation/audit work plans, performing investigation/audit procedures, documenting work, reporting findings, and developing and implementing appropriate remediation; Perform proactive process and control backssments of policies, procedures and clinical IT systems; Define and understand potential compliance issues, collect and analyze large amounts of data, perform research, identify root causes of potential issues, and evaluate risk
to make timely and appropriate decisions; Utilize Excel, Access, and other tools to perform qualitative and quantitative analyses on large amounts of clinical and billing data and develop presentations to communicate the results of such analyses to compliance and operations management; Conduct multiple projects concurrently while managing timelines with their manager and internal customers and assist their manager with projects related to the overall compliance audit and monitoring programs; Draft written presentations to compliance and operations management to inform decision making; and No direct reports.
Qualifications Bachelors 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 (e.
g. process and control backssments); 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 (Cf C), Conditions for Participation (Cf P), 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, Power Point, and Access including experience with using these tools to create data analytics (e.
g. Pivot Table, Vlookup, etc. ); A thoughtful, articulate and effective critical thinker and communicator who can distill and articulate the important aspects of any issue; 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; and Hands on, efficient and proven ability to Get Stuff Done with a bias for action and a strong sense of ownership.
Limited travel required: up to 10%
IT jobs refer to positions in the field of Information Technology, a sector dedicated to computing technology, telecommunications, and data management. These jobs typically involve the design, development, implementation, support, and management of computer-based information systems. Key characteristics of IT jobs include a focus on problem-solving, continual learning due to rapidly evolving technologies, and a blend of technical proficiency with soft skills like teamwork and communication. Roles can range from software developers and system analysts to network engineers and cyber security specialists, all contributing to the technological backbone of modern businesses.
IT jobs refer to positions in the Information Technology sector, which encompasses a vast array of roles focused on the creation, maintenance, and support of computer systems and networks. These roles include but are not limited to software development, systems analysis, network engineering, and cybersecurity. IT professionals often possess strong problem-solving skills, an aptitude for continuous learning due to the fast-paced evolution of technology, and the ability to adapt to new tools and practices. Their work is crucial for businesses as they ensure the efficient operation of digital infrastructures that support various organizational functions and safeguard data.
IT jobs refer to positions focused on the development, implementation, support, and management of computer-based information systems. These roles often require skills in programming, system analysis, hardware and networking, database management, and cybersecurity. Characteristic features of IT jobs include a strong emphasis on problem-solving, continual learning to keep up with rapid technology changes, and the potential for remote work given the digital nature of the field. IT professionals might work in various industries, from tech corporations to financial services, health care, and government sectors.
IT jobs refer to employment within the field of information technology, an industry centered on the creation, maintenance, and support of computer systems and networks. Characteristically, these roles demand technical expertise in areas such as software development, cybersecurity, and data analysis. IT professionals are typically required to quickly adapt to new technologies and solve complex problems, often working in dynamic, fast-paced environments. The sector is known for its diverse career opportunities and has become essential across virtually all business sectors, reflecting the critical role technology plays in modern society.
