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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Legal Staff
Health Care
2-3 yrs required
Compliance Policy Analyst The candidate responsible for assisting the Director, Quality and Compliance in developing, maintaining and administering the Compliance Program, to ensure continued compliance with federal, state, local and accrediting agency requirements. Monitor and disseminate information from compliance resources, including the Department of Health and Human Services, the Center for Medicare and Medicaid Services, the Office of Civil Rights, the Office of the Inspector General, the Wisconsin Department of Health Services, the Applicable accreditation program(s); National Hospice and Palliative Care Organization, as well as other resources with relevant hospice and health care compliance-related information. Participate in the identification of risk areas, analyze areas of immediate concern. Work collaboratively with clinical leaders and other staff to identify and resolve compliance-related issues, including the development and implementation of processes to address compliance concerns. Support the review and revision of policies & procedures, forms, manuals, and reference materials to ensure compliance with applicable regulations and agency standards. Educate staff on compliance policies and regulations and assist in the development of compliance education and training materials. Assist with the development and implementation of audit/monitoring programs to measure performance against compliance obligations. Coordinate responses to findings from internal and external monitoring and audit activities, including requests from the Center for Medicare and Medicaid Services and its contractors. Assist in drafting correspondence to patients and families, when compliance issues are involved.
Qualification and Experience
An Associates Degree, required, Bachelor’s degree, preferred. Certification/Registration/Licensure: paralegal and/or health care compliance certification, preferred. 2-3 years experience with health care compliance, health care policy analysis, auditing, billing, coding, reimbursement and/or information management, required. 3 years experience in business or clinical operations in a clinical setting, required. In-depth working knowledge of regulatory and operational aspects of health care, required. Knowledge of medical terminology, coding and payment methodologies, billing, information systems, health documentation and quality monitoring processes, required. Microsoft Office competency, required. Must be detail-oriented with strong analytical, research, and organizational skills.
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