Compliance Analyst
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility.
The Shared Services Team is seeking a new team member who thrives in a highly collaborative team oriented environment. The Compliance Analyst position requires supporting the Claims Division with all facets of Medicare and SCHIP reporting processes and assistance with general claims compliance requirements (as needed).
Responsibilities
- Meet the Compliance Guidelines of CMS (Centers for Medicare Services) through knowledge of 5 Fields for eligibility determination; as well as ICD Codes, TPOC (Total Payment to Claimant) and ORM (Ongoing Responsibility for Medial)
- Maintain a close relationship with vendor partner to access reports and data in vendor dashboard and MSP Navigator tool.
- Complete Missing Section 111 data, compare missing eligibility information to RMA
- Monitor CP Link, present claims for review when necessary, forwarding and following up on Treasury Notices with Examiners.
- Address any CMS alerts that arise.
- Update Arch's CMS / SCHIP Policies & Procedures Manual and Workflows as needed.
- Assist Compliance team with other aspects of Claims Compliance as necessary.
Experience and Required Skills
Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and WordExceptional communication (written and verbal), influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal / external peers and other professionals across organizational linesStrong problem-solving, analytical, organizational, and time management skillsAdvanced attention to detail ensuring work product accuracyApplies critical thinking and produces information to identify key issuesEducation
Bachelor's degree preferredIn-house and insurance / reinsurance experience; either or both preferredMinimum of one year plus experience working preferably with insurance compliance / Medicare issues or equivalent.Base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110 / year
Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more.Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.