Sr. Revenue Cycle Compliance Analyst

Adventist Health; Roseville (CA); Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

A healthcare organization in Roseville, California, is seeking a Sr. Revenue Cycle Compliance Analyst. The role involves coordinating and analyzing compliance within the revenue cycle, providing analytics to support the organization, and ensuring adherence to regulations and policies. Candidates should have at least an Associate’s Degree and relevant experience in revenue cycle processes, along with certifications like RHIT or CCS. This is a full-time, mid-senior level position.

Qualifications

• Five years’ practical work experience within Revenue Cycle (HIM, PFS or CDM) preferred.
• Certification in one or more: RHIT, RHIA, CCS, CPC recommended.

Responsabilités

• Coordinates and analyzes events and transactions for regulatory compliance.
• Provides analytic support to assigned functional areas.
• Participates in hotline investigations related to revenue cycle.

Connaissances

Regulatory compliance analysis

Data analysis

Knowledge of revenue cycle

Formation

Associate’s Degree or equivalent

Bachelor's Degree or equivalent

Outils

DA2

Power Insight Explorer (PIE)

Compliance 360

MDaudit

Description du poste

Overview

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Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary

Coordinates and analyzes events and transactions for regulatory compliance. Evaluates, monitors, and communicates the corporate compliance program to the organization, its members and affiliates. Partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or corporate entities. Provides analytic support to assigned functional areas. Places emphasis on revenue cycle compliance.

Job Requirements

Education and Work Experience:

• Associate’s Degree or equivalent combination of education/related experience: Required
• Bachelor's Degree or equivalent combination of education/related experience: Preferred
• Five years’ practical work experience within Revenue Cycle (HIM, PFS or CDM): Preferred

Licenses/Certifications

• One or more of the following: AHIMA: RHIT, RHIA, CCS, CCS-P, CDIP, CHDA
• AAPC: CPC, COC, CIC, CPB, CPMA
• HFMA: CRCR
• HCCA: CHC: Preferred

Essential Functions

• Works alongside revenue cycle compliance leadership, corporate compliance departmental staff, legal counsel and paralegals to determine if the revenue cycle is functioning in accordance with state and federal guidelines. Responds to and evaluates reported revenue cycle compliance concerns. Analyzes issues and assigns appropriate revenue cycle individuals to work cases. Monitors cases and ensures completion. Tracks completion statistics.
• Participates in the hotline investigations as they pertain to revenue cycle and helps ensure issues are resolved in an efficient and timely manner.
• Performs probe audits at the request of compliance leadership to determine extent of identified compliance concerns across the system. Helps monitor and track regulatory audit statistics such as RAC, TPE, PPR and CERT.
• Provides data analysis and support from a variety of sources, including but not limited to: DA2, Power Insight Explorer (PIE), Compliance 360 and MDaudit. Helps with monitoring RevCycle staff completion of required compliance education in HealthStream.
• Monitors legislation and regulations involving compliance-related issues, such as patient billing and coding, etc. Communicates the organization's Code of Conduct to all employees, refreshes employees’ knowledge of the Code of Conduct.
• Support MD Audit and assist users ensuring they have skills and education to work within MD Audit.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

About Us

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God\'s love by inspiring health, wholeness and hope.

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Legal
• Industries: Hospitals and Health Care