Additional Information: Full benefits and a $7,500 annual bonus potential are available.

Description: Our Client, a provider of kidney dialysis services, is hiring a Senior Analyst, Clinical & Billing Investigations (Healthcare Compliance) in Denver, CO.

Responsibilities:

• Investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems;
• Conduct IT system investigations and audits including performing risk assessment, scoping investigation / audit, developing investigation / audit work plans, performing investigation / audit procedures, documenting work, reporting findings, and developing and implementing appropriate remediation;
• Perform proactive process and control assessments 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;
• Limited travel required: up to 10%.

Requirements:

• Experience as an investigative, audit, compliance, or legal professional responsible for compliance investigations, external / internal audits, and consulting projects (e.g., process and control assessments) (3 years);
• Experience working with Medicare Fee for Service claims and respective electronic health record and billing IT systems;
• Experience working for Big 4 or mid-sized audit firms, other consulting firms, or a healthcare company;
• 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 (CfC), Conditions for Participation (CfP), and other CMS Manuals (preferred);
• Project management experience;
• Experience positively and successfully managing relationships with a high energy and diverse group of internal customers across organizational lines;
• Experience with Excel, PowerPoint, and Access including using these tools to create data analytics (e.g., Pivot Table, Vlookup, etc.);
• Certification in Healthcare Compliance (preferred);
• Bachelor’s degree required;
• JD/CPA/CIA/MBA or other relevant advanced degree or certification (preferred).

Why Apply?

• Join a Fortune 500 health care provider focused on transforming care delivery to improve quality of life for patients around the globe;
• Work with a stable company with a track record of success and growth since 1999;
• Benefit from health insurance and care offered to employees;
• Become eligible for 401(k) plan, employee stock purchase plan, life and family insurance plan, family resources and discounted child care, military and veteran program;
• Enjoy compensation and PTO, donations and village support, retail and commuter discounts.

If this job is not for you, earn a $2,100.00 referral bonus in cash by referring a Candidate or a Client to us. Vitaver Referral Program is one of the most generous on the market!

Please feel free to apply directly and contact me with your questions at [email protected]