Senior Risk Analyst - Rev
About The Position
The Senior Risk Analyst works closely with Revenue Compliance leadership and analysts, Revenue Cycle, Clinical Documentation Improvement programs, and other groups to support compliance initiatives focused on Medicare Conditions of Participation, billing regulations, and coding guidelines. The role reviews patient medical records to proactively assess billing accuracy and supports colleagues through coaching, training, project delegation and oversight, status updates, and scheduling. The position monitors internal and external revenue compliance risks and supports compliance through interpretation and analysis of billing standards. It serves as a resource to the Practice and Revenue Cycle on policies, procedures, and applicable regulations, and works with Mayo Clinic leadership to enforce policy compliance while mitigating organizational risk. The role drafts and updates policies, oversees implementation of procedures, leads multidisciplinary workgroups and projects, assists with investigations, and responds to complaints filed with regulatory agencies. It also represents compliance on institutional committees and other assigned functions and projects. Some travel to other Mayo Clinic sites and/or training conferences may be required. The position is not eligible for visa sponsorship or transfer, and Mayo Clinic does not participate in the F-1 STEM OPT extension program.
Requirements
- Bachelor's degree.
- At least 5 years of experience in healthcare, internal audit, clinical, regulatory research, compliance, Legal, and/or Revenue Cycle.
- Ability to maintain the highest level of confidentiality.
- Healthcare provider or payer experience.
- Knowledge of federal and state regulations related to Medicare, Medicaid, and billing compliance.
- Effective training and presentation skills.
- Complex investigation and audit experience.
- Proficiency in Excel, Word, and PowerPoint.
- Ability to set priorities and respond to changing demands from multiple sources.
- Ability to follow through, meet regulatory deadlines, anticipate requirements, and build relationships.
- Strong analytical and problem-solving skills.
- Ability to communicate effectively with diverse groups, including attorneys, physicians, patients, allied health staff, researchers, and vendors.
- Ability to lead in a team environment with minimal supervision.
Nice To Haves
- Experience in a healthcare company with knowledge of existing and emerging federal and state revenue compliance requirements.
- Master’s degree or Juris Doctor degree.
- Compliance certification such as Certified in Healthcare Compliance (CHC) or similar.
- One or more of the following credentials: Registered Nurse (RN), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), Certified Risk Adjustment Coder (CRC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Documentation Improvement Practitioner (CDIP), or Certified Clinical Documentation Specialist (CCDS).
Responsibilities
- Review patient medical records to proactively assess billing accuracy.
- Support compliance program initiatives involving Medicare Conditions of Participation, billing regulations, and coding guidelines.
- Provide colleague support through coaching, training, project delegation and oversight, regular status updates, and scheduling.
- Monitor internal and external revenue compliance risks and support compliance through interpretation and analysis of billing standards.
- Serve as a resource for the Practice and Revenue Cycle on policies, procedures, and applicable regulations.
- Work with Mayo Clinic leadership to enforce policy compliance and mitigate organizational risk.
- Draft and update policies and oversee implementation of procedures.
- Lead multidisciplinary workgroups and projects.
- Assist with investigations and respond to complaints filed with regulatory agencies.
- Represent compliance on institutional committees and other assigned functions and projects.
Benefits
- Medical plan options.
- Dental coverage through Delta Dental or a reimbursement account for flexible coverage.
- Vision plan with a national network.
- Health Savings Account (HSA) and Flexible Spending Accounts (FSA) for eligible expenses.
- Competitive retirement package.
- Continuing education and advancement opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
