Compliance Analyst

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.
It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do - in the health of our patients, our loved ones, and our community.
Benefits Eligible
Full-Time Benefit Eligible
Work Shift
Day (United States of America)
Department
8895 Compliance Program
To provide technical, administrative and educational support to the Compliance Program and to ensure that regulatory requirements are met for an effective Compliance Program.
NOT A REMOTE POSITION. ON-SITE ONLY.
Education
Required:N/A
Preferred:Bachelor's degree with emphasis in health care, accounting, business or in a closely related field.
Experience
Required:At least five years of hospital reimbursement, auditing, billing, compliance, or coding experience.
Essential
Under the direction of the Kaweah Health Compliance Officer and/or Compliance Manager, supports internal compliance investigations and audits throughout the Kaweah Health, including compiling detailed reports with recommendations to the Compliance & Privacy Officer, Management and the Board of Directors.
Oversees the management of the Kaweah Health's Policy Management and Governmental Auditing tools.
Under the direction of the Kaweah Health Compliance Officer and/or Compliance Manager, monitors corrective action and completes appropriate follow up work to ensure that Management's Action Plans are completed within the established time frames.
Participates as an active member of the Audit and Compliance Committee, including preparation of the agenda, board packets, and meeting minutes.
Under the direction of the Kaweah Health Compliance Officer and/or Compliance Manager, completes audits and reviews.
Maintains the Compliance Statement of Concern Log, documenting issues, findings and corrective actions taken towards issue resolution.
Coordinates and monitors the process of searching the OIG exclusion database to ensure that the Kaweah Health does not hire, employ, contract with and/or provide medical privileges to anyone excluded from participation in Federal or State Health Care Programs.
Coordinates the response, tracking, and appeals management of governmental record requests including but not limited to the Medicare Recovery Audit Contractor (RAC) and certain requests from the Medicare Administrative Contractor (MAC) (i.e. Probe Additional Data Requests).
Coordinates work of contracted external coding and billing consultants; works collaboratively with Health Information Management, Patient Account Services and other pertinent departments on audit findings and development of corrective action steps.
Researches regulations, monitors new laws, keeps fully abreast and informed of compliance, Patient Privacy, HIPAA related topics and assists with evaluation of potential risk areas and issues.
Works collaboratively with Patient Accounting, HIM, Case Management, and Patient Access to review protocols, complete audits, and support development of risk mitigation strategies.
Addendum (essential for specific dept)
Additional
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Performs other duties as assigned.
Pay Range
$25.28 -$37.92
If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.