Compliance Analyst & Support
About The Position
We are looking for a Compliance Analyst and Support to join our ProgressiveHealth team! This person will be responsible for monitoring revenue cycle processes to ensure process integrity, proper and expeditious billing, optimal reimbursement, superior client service, and compliant operations. Immediate feedback and corrective actions are prescribed for process participants to rectify any shortfalls or implement improvement opportunities quickly. This position requires confidentiality, prioritizing, and organization and reports to the Compliance Officer and Internal Corporate Counsel. This is a Monday-Friday, day shift position at our Central Operations located on Evansville, IN’s westside. This position is a full-time, in-office opportunity.
Requirements
- College graduate or commensurate experience
- Previous experience in monitoring, auditing, compliance, and reimbursement
- Exceptional organization skills, self-motivation, and demonstrated excellence in customer service and communication
- Ability to adapt quickly to change, problem solve, and be solution-oriented
- Strong sense of urgency with the ability to execute quickly and efficiently with keen attention to detail
- Highly organized with strong follow-up skills and the ability to multi-task
- A high degree of professionalism in both written and verbal communication
- Ability to work both independently and in a team environment, without constant supervision
- Ability to maintain confidentiality
- Strong computer skills, including proficiency with databases and Microsoft Office applications, including Outlook, Word, PowerPoint, and Excel
- This position requires candidates to be authorized to work in the United States on a full-time basis without requiring current or future sponsorship for an employment visa (e.g., H-1B, OPT, etc.).
Nice To Haves
- Previous experience in the healthcare industry is ideal, preferably in physical and occupational therapy services
Responsibilities
- Review active accounts to validate if the account has been worked by the assigned account representative in the previous month
- Review denial reports, tally the amount of denials for each denial code, and sort into groups by payer
- Validate payments on accounts for accuracy at contracted rate, posting of payment, and timeliness of the refund before the refunds are posted
- Conduct charge capture by reviewing scheduled minutes of therapist versus billed minutes, ensuring full charge capture; provide timely feedback to capture missed charges
- Conduct claims reviews to ensure remittance was posted correctly per the EOB
- Review accounts to monitor the registration process
- Perform Plan of Care Certification reviews
- Perform clinical documentation chart reviews
- Create reports and implement plans of correction based on review findings, if necessary
- Prepare and submit reports in a timely fashion
- Collaborate with audit and compliance functions as necessary
- Provide weekly reporting to the Compliance Manager regarding results of process monitoring
- Conduct regular, ongoing monitoring of revenue cycle and front office functions
- Identify process shortfalls, prioritizing inspection based on value of opportunity or risk
- Provide immediate feedback to the Revenue Cycle Director, Compliance Manager, Compliance Officer, process participants, and COO, as appropriate, including suggested corrective actions and timelines
- Support the Compliance Department with needed tasks
- Other duties as assigned
Benefits
- Opportunity for important work/life balance with flexible scheduling!
- Paid time off (PTO) & paid holidays
- A robust benefits package: medical (HSA/FSA availability), dental, vision, and supplemental insurance options
- Health improvement plan opportunities to lower premium costs
- FREE use of the ProCare HealthSpot medical clinic for insured employees and dependents
- Includes medical care, virtual visits with a 24/7 nurse call line, lab testing, and generic medications
- Company-sponsored basic life/AD&D insurance and long-term disability insurance
- 401(k) & ROTH 401(k) savings plans + company match with auto-enrollment after probationary period
- Continuing professional development
- Opportunities for growth and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
251-500 employees
