Compliance Associate, II
Northwestern Medicine
full-time
Posted on:
Location Type: Remote
Location: Remote • Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $34 - $47 per hour
Job Level
JuniorMid-Level
About the role
- Help manage all aspects of the Compliance Hotline and compliance issues received via e-mail and phone
- Help ensure reported issues are appropriately received, evaluated, investigated, documented, and resolved
- Primary responsibility for auditing/reviewing provider documentation, coding, and billing to ensure that the documentation supports the CPT codes billed to government payors
- Results of the provider audits/reviews are shared with the provider
- Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements
- Work with Senior/Manager/Director on more complex issues or investigations
- Respond to queries or allegations and triage issues to appropriate departments when necessary
- Assist with maintaining a log/database of all issues received by the department through the compliance hotline, e-mails, phone calls, etc.
- Document all issues received, actions taken, and resolutions
- Maintain a current understanding of regulatory trends and changes in compliance and regulatory guidelines that affect NMHC and its subsidiaries
- Coordinate investigations in response to incoming compliance related issues
- Gather all relevant information for potential compliance issues, determine underlying causes, and relate information from different sources to draw logical conclusions
- Coordinate non-coding and non-billing related audits, reviews and investigations
- Perform follow-up, audits, reviews, investigations, and validations
- Assist with data analysis to determine root cause of reported or identified issues and determine level of escalation required
- Assist with the development of compliance education and training materials
- Assist departments in the development of corrective action plans for identified issues
- Assist with the development and implementation of the departments annual Compliance Work Plan
- Help develop and maintain compliance-related policies and procedures to ensure they are current and relevant
- Assist with providing policy-related guidance to individuals and departments
- Perform other duties assigned by the department Managers, Director, or VP, Integrity
Requirements
- Bachelor's Degree
- Demonstrated ability to work with various levels within the organization regarding confidential information and maintain sensitive data
- Strong interpersonal and communications skills required
- Ability to work collaboratively and communicate with others in a clear, concise, and professional manner on the telephone and in person, as well as demonstrate use of good written and verbal communication skills
- Knowledge and experience in using Word, Excel, PowerPoint, Access and similar Office programs
- Certified Healthcare Compliance (CHC) certification (preferred)
- CPC, RHIA or similar credential (preferred)
- JD, MBA or similar degree (preferred)
- Healthcare compliance experience (preferred)
Benefits
- tuition reimbursement
- loan forgiveness
- 401(k) matching
- lifecycle benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
auditingprovider documentation reviewcodingbillingdata analysisinvestigationsroot cause analysiscompliance education developmentcorrective action planningpolicy development
Soft skills
interpersonal skillscommunication skillscollaborationconfidentialityprofessionalismproblem-solvinglogical reasoningattention to detailorganizational skillsadaptability
Certifications
Certified Healthcare Compliance (CHC)CPCRHIAJDMBA