Compliance Analyst

What You’ll Do

• Internal Controls
  • Conduct detailed audits of compliance concerns including medical records to ensure accuracy in coding and billing practices.
  • Review documentation to identify and correct coding and billing errors, ensuring compliance with medical necessity and regulatory guidelines.
  • Log and track audit results and documentation workflows.
  • Analyze trends and discrepancies in coding and billing practices, providing actionable insights and recommendations for improvement.
  • Collaborate with internal teams to improve documentation standards and ensure compliance with relevant regulations.
  • Independently organize and prioritize audit tasks to meet deadlines, adjusting priorities as necessary.
  • Participate in process improvement initiatives, team meetings, and department projects to enhance audit workflows and overall efficiency.
  • Maintain up-to-date knowledge of medical coding standards, HIPAA regulations, and compliance requirements.
  • Provide recommendations to management on improving coding accuracy, documentation standards, and operational processes.
• Reporting
  • Deliver adequate and timely reporting on the internal control framework and control deficiencies to ensure appropriate communication, documentation, escalation to the compliance officer.
• Team Collaboration
  • Cross functionally collaborate with department heads and build strong communication lines to maintain compliance.