Clinical Audit Operations and Consulting Analyst

Confluent Health

6d•Remote

About The Position

The Clinical Audit Operations and Consulting Analyst, as a member of the Confluent Health Compliance Department, will conduct auditing activities to monitor compliance with federal, state and payer guidelines. This role includes the performance of clinical audits, evaluating clinician documentation and billing practices as it relates to applicable regulations. The role coordinates closely with Confluent Health leadership to provide consultation and recommendations to facilitate corrective action. This is a full-time, remote position.

Requirements

Must possess the ability to communicate effectively and professionally with all levels of management, employees and outside contacts
Sound problem solving, decision making and policy interpretation skills
Strong attention to detail, organizational and time management skills
Ability to remain calm in stressful situations
Must possess the ability to work independently and be self-motivated
Must display high standards of ethical conduct
Strong knowledge of PT/OT/SLP documentation, billing and regulatory standards
Licensed PT/OT/PTA/OTA with a minimum of 5 years working in the clinic setting or in a compliance function

Responsibilities

Monitoring compliance with current laws, process improvements and implementation of clinical best practices
Assessing clinical documentation to identify potential areas of risk as it relates to billing and reporting of data
Providing guidance and consultation to company leaders regarding clinical documentation best practices within the organization’s EMR system
Ensuring that clinical reviews are performed based on State Practice Act, Payer Policy and Local Coverage Determination requirements