Maxim Healthcare Corporate Services is currently seeking a Compliance Analyst II. The Compliance Analyst II must maintain a comprehensive understanding of ethical principles and independence in their work. The Compliance Analyst II maintains the highest level of personal and professional conduct, duty, and responsibilities; additionally, this individual must remain objective and independent in all assignments. This position requires strict confidentiality with all compliance matters.
Essential Duties and Responsibilities:
Manages the repayment process from identification to refund completion
Receives repayment notifications from various departments (Compliance, Legal, etc.) and reviews repayment requests for completeness; calculates repayment total as needed and or confirms that the repayment was accurately calculated; determines method of repayment if necessary and or routes to the appropriate location
Researches late timecards, patient loggings, reconciliations, etc.
Summarizes ad hoc audit findings and preliminary recommendations for management review
Prepares reports and reviews audit findings with Team Leads and OSM’s as needed
Works with multiple departments on repayment matters as necessary
Obtains billing and medical record information used to support Maxim’s claims for reimbursement
Analyzes billing and medical record information to test for completion, accuracy, and conformance with policy, procedure, and reimbursement requirements
Compiles a report of billing and repayment determinations for distribution to the Regional VP, Controller, OSM, RCO and Claims Testing Department
Evaluates and examines internal controls for adequacy
Reviews management procedures and financial systems for accuracy
Answers inquiries and provides data to executives, management, auditors, and agencies as appropriate
Ensures that all testing and information related to findings and proposed recommendations are appropriately documented and explained in an organized set of work papers
Assists with Compliance-related investigations as needed
Participates in educational activities to ensure quality-related concerns are captured, communicated and addressed as needed
Participates in weekly conference calls and team meetings
Maintains current knowledge of rules, regulations and reimbursement issues
Ensures confidentiality of all information, especially medical information as related to the HIPAA regulations
During all phases of a review, maintains a positive working relationship with all employees to ensure that all work related encounters are productive
Performs other duties as assigned/necessary
Minimum Requirements:
BA/BS required; degree(s) Healthcare Economics, Health Information Management and/or
Business (Accounting/ Finance) preferred
Prior auditing experience preferred
At least three (3) years of experience in healthcare
Ability to maintain positive professional business relationships
Strong project management skills
Strong organizational and interpersonal skills, along with strong attention to detail
Ability to set priorities and meet time lines for performance expectations
Able to work independently with minimal supervision and demonstrates initiative
Excellent oral and written communication skills
Ability to professionally and confidentially handle personal information and maintain HIPAA Compliance
Adaptability to change and ability to prioritize competing duties
Must be detail-oriented
Computer proficiency, including Microsoft Office
Must be ethical and possess the ability to remain impartial and objective
Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language may be required
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health Advocate Employee Assistance Program
Retirement and Financial Security: Employee Assistance Program, Health Savings Account, 401(k) + Company Match, Profit Sharing, Short and Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance discounts, Pet Insurance and Legal benefits
Lifestyle Benefits: Paid Time Off and Company Paid Holidays, Transportation Benefits, Educational Assistance Program, College Partnership Program and Employee Discount Program
*Benefit eligibility is dependent on employment status.
About Maxim Healthcare
Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare, Inc. (“Maxim”) is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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