Revenue Cycle Compliance Analyst

Overview

This position offers remote flexibility but requires availability for on-site visits as necessary.

Performs routine and ad hoc auditing of all revenue cycle functions to ensure alignment with regulatory requirements. Researches and analyzes statutes, regulations and guidance documents published at both the federal and state level. Designs and delivers educational content intended for providers and leadership. Serves as a subject matter expert on revenue cycle compliance, providing informed guidance and addressing inquiries from both internal and external stakeholders. Prepares formal responses to regulatory agencies, including entities such as the Attorney General, as appropriate.

Qualifications

Certifications : Certified in Healthcare Compliance (CHC) within 2 years - Health Care Compliance Association (HCCA); Registered Health Information Technician (RHIT) within 1 year - American Health Information Management Association (AHIMA); Registered Health Information Administrator (RHIA) within 1 year - American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) within 1 year - American Academy of Professional Coders (AAPC); Certified Coding Specialist (CCS)within 1 year - American Health Information Management Association (AHIMA), Education : Bachelor's Degree : Related Field (Required), Work Experience : Revenue cycle

Responsibilities

Completes primary and secondary regulatory research, assessment of organizational risk based on industry trends, billing guidelines issued by governmental authorities and regulatory changes.Conducts routine and targeted audits of revenue cycle functions, including annual work plan audits.Drafts reports / summaries of audit findings and reviews.Supports HIM coding audit team.Identifies and quantifies refunds due payers.Performs investigations of billing / coding processes.Represents Compliance, as needed, on committees, at meetings, and other discussions, as appropriate.Collaborates with Carle departments such as Patient Financial Services, Health Information Management, and other organizational stakeholders.Serve as a subject matter expert for revenue cycle compliance matters.Facilitates and promotes implementation of Compliance initiatives, documentation and reporting obligations.Partners with internal stakeholders in communicating with payors regarding denials or audit resolution.Develops education intended for providers and leadership.Prepare formal responses to regulatory oversight bodies, as appropriate.Serve as a neutral party when involved in investigations and issue resolution maintaining the best interests of the organization at all times. Respond timely to requests for guidance or assistance. Escalate issues as appropriate and expected of an Effective Compliance Program.

About Us

Find it here.

Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health.

Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in its eight hospitals, physician groups and a variety of healthcare businesses. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet designations, the nation's highest honor for nursing care. The system includes Methodist College and Carle Illinois College of Medicine, the world's first engineering-based medical school, and Health Alliance. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information : human.resources@carle.com.

Compensation and Benefits

The compensation range for this position is $23.36per hour - $39.01per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate's experience, qualifications, location, training, licenses, shifts worked and compensation model.

Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org / benefits.