Compliance Analyst

Spire Orthopedic Partners•Stamford, CT

6d•Onsite

About The Position

The Healthcare Compliance Analyst supports the compliance program for a Management Services Organization (MSO) serving orthopedic physician practices. This role focuses on regulatory compliance related to surgical and procedural services, physician arrangements, revenue cycle operations, and ancillary services such as imaging, physical therapy, and durable medical equipment (DME). The analyst partners with physicians, practice leadership, and MSO departments to identify compliance risks, conduct audits, and ensure adherence to federal and state regulations across multiple orthopedic practice sites.

Requirements

Bachelor’s degree (required) with a focus in Healthcare Administration, Business, Public Health, or related field (preferred).
5-7 years of experience in healthcare compliance with specific experience in provider, hospital, payer, or healthcare services environment preferred.
Knowledge of Stark Law, Anti-Kickback Statute, and physician practice compliance requirements
Knowledge of healthcare regulatory requirements, including HIPAA, Medicare/Medicaid regulations, fraud and abuse laws, and compliance program fundamentals.
Strong analytical, organizational, and problem-solving skills.
Ability to interpret regulations and apply them to operational processes.
Excellent written and verbal communication skills.
Proficiency with Microsoft Office applications and compliance-related reporting tools.
Ability to work independently and collaboratively in a fast-paced environment.
Strong attention to detail and ability to manage multiple priorities.

Responsibilities

Assist in the implementation and maintenance of the organization’s compliance program.
Monitor and evaluate compliance with federal, state, and local healthcare regulations and organizational policies.
Conduct routine compliance audits, reviews, and monitoring activities related to billing, coding, documentation, privacy, and operational practices.
Analyze audit findings, identify trends or potential risks, and prepare reports with recommendations for corrective action.
Support investigations of compliance concerns, complaints, or potential violations.
Maintain accurate documentation related to audits, investigations, corrective action plans, and compliance activities.
Assist with the development and delivery of compliance education and training materials for employees and providers.
Monitor regulatory updates and assist in assessing organizational impact and implementation needs.
Collaborate with operational leaders and departments to support compliance initiatives and risk mitigation efforts.
Participate in policy and procedure review and development to ensure regulatory alignment.
Support preparation for external audits, accreditation reviews, and regulatory inquiries.
Maintain confidentiality and handle sensitive information in accordance with organizational standards and privacy regulations.