Senior Compliance Analyst chez AdventHealth

%3Cp class=%22MsoNormal%22 style=%22margin-bottom:12.0pt;mso-margin-top-alt:auto;%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EAll the benefits and perks you need for you and your family:%3C/strong%3E%3C/span%3E%3C/span%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3E%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22background-color:white;margin-bottom:12.0pt;margin-left:42.0pt;mso-list:l4 level1 lfo1;mso-margin-top-alt:auto;tab-stops:list .5in;text-indent:-.25in;%22%3E%3Cspan style=%22color:black;font-family:Symbol;font-size:10.0pt;%22%3E%3Cspan style=%22mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E·%3C/span%3E%3Cspan style=%22font:7.0pt %26quot;Times New Roman%26quot;;mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E%26nbsp;%26nbsp;%26nbsp;%26nbsp; %3C/span%3E%3C/span%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EBenefits from Day One%3C/span%3E%3C/span%3E%3Cspan style=%22color:black;font-family:%26quot;Open Sans%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22background-color:white;margin-bottom:12.0pt;margin-left:42.0pt;mso-list:l4 level1 lfo1;mso-margin-top-alt:auto;tab-stops:list .5in;text-indent:-.25in;%22%3E%3Cspan style=%22color:black;font-family:Symbol;font-size:10.0pt;%22%3E%3Cspan style=%22mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E·%3C/span%3E%3Cspan style=%22font:7.0pt %26quot;Times New Roman%26quot;;mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E%26nbsp;%26nbsp;%26nbsp;%26nbsp; %3C/span%3E%3C/span%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ECareer Development%3C/span%3E%3C/span%3E%3Cspan style=%22color:black;font-family:%26quot;Open Sans%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22background-color:white;margin-bottom:12.0pt;margin-left:42.0pt;mso-list:l4 level1 lfo1;mso-margin-top-alt:auto;tab-stops:list .5in;text-indent:-.25in;%22%3E%3Cspan style=%22color:black;font-family:Symbol;font-size:10.0pt;%22%3E%3Cspan style=%22mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E·%3C/span%3E%3Cspan style=%22font:7.0pt %26quot;Times New Roman%26quot;;mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E%26nbsp;%26nbsp;%26nbsp;%26nbsp; %3C/span%3E%3C/span%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EWhole Person Wellbeing Resources%3C/span%3E%3C/span%3E%3Cspan style=%22color:black;font-family:%26quot;Open Sans%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22background-color:white;margin-bottom:12.0pt;margin-left:42.0pt;mso-list:l4 level1 lfo1;mso-margin-top-alt:auto;tab-stops:list .5in;text-indent:-.25in;%22%3E%3Cspan style=%22color:black;font-family:Symbol;font-size:10.0pt;%22%3E%3Cspan style=%22mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E·%3C/span%3E%3Cspan style=%22font:7.0pt %26quot;Times New Roman%26quot;;mso-bidi-font-family:Symbol;mso-fareast-font-family:Symbol;mso-list:Ignore;%22%3E%26nbsp;%26nbsp;%26nbsp;%26nbsp; %3C/span%3E%3C/span%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMental Health Resources and Support%3C/span%3E%3C/span%3E%3Cspan style=%22color:black;font-family:%26quot;Open Sans%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22margin-bottom:12.0pt;mso-margin-top-alt:auto;%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EOur promise to you:%3C/strong%3E%3C/span%3E%3C/span%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22margin-bottom:12.0pt;mso-margin-top-alt:auto;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EJoining AdventHealth is about being part%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22margin-bottom:12.0pt;mso-margin-top-alt:auto;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3Eof something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that %3Cstrong%3Etogether%3C/strong%3E we are even better.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EShift%3C/strong%3E:%26nbsp;%3C/span%3E%3C/span%3E%3Cspan style=%22font-family:%26quot;Proxima Nova%26quot;;%22%3E%26nbsp;%3C/span%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-spacerun:yes;%22%3E %3C/span%3EMonday-Friday 8am-5pm hybrid (Monday, Wednesday, Thursday Onsite)%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Co:p%3E %3C/o:p%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EJob Location%3C/strong%3E%3C/span%3E%3C/span%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E:%26nbsp;%3C/span%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;mso-spacerun:yes;%22%3E %3C/span%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMaitland, FL%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:#222222;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E %3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E %3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EThe role you will contribute:%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22mso-layout-grid-align:none;tab-stops:.75in;text-autospace:none;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Co:p%3E %3C/o:p%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:Verdana;%22%3EThe Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify, quantify, and present contract compliance violations. He/she will perform extensive review of contract language, state and federal regulations, and payor practices to facilitate resolution of contract non-compliance. This person demonstrates attention to detail and competencies in contract language review, research, decision support, and financial analysis in the preparation and support of payor arbitrations. This person is responsible for compiling and analyzing multiple sources of data to support executive decision-making regarding contract violations. The Senior Compliance Analyst will have expertise in Commercial and Governmental (Medicare, Medicaid, Tricare) payer reimbursement language and methodologies. The Senior Compliance Analyst works with Managed Care staff in all AH Divisions, as well as payers in all markets. Actively participates in outstanding customer service and maintain relationships with clients who include AH Managed Care Directors, Contract Denial Specialists, other AdventHealth departments, payers and legal counsel.%3C/span%3E%3C/span%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3E%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:#006197;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EThe value you will bring to the team:%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Co:p%3E %3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EContract Compliance-60%%3C/strong%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EPerforms contract language review in accordance with state statutes, federal regulation and AdventHealth Managed Care policy.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMaintain and report contract violations by payor, hospital, and AH Division to include related financial impact.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EManage payor legal action through research, damages calculations, and organizing data/materials from other AdventHealth departments (i.e. medical records, itemized bills, etc.) within the scheduled timeframes.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ECalculate and manage damages spreadsheets throughout any settlement, mediation, arbitration or lawsuits.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAudit current contracts for potential revenue opportunities and contract violations for all payer types.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAnalyze, understand, and articulate regulatory and contractual requirements and apply identified requirements to business operations.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EFacilitate resolution to contract violations by leveraging knowledge of state Insurance and Managed Care laws and state reporting requirements for HMO/Insurance companies.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EFacilitate resolution to contract violations by leveraging knowledge of Medicaid contract requirements, regulations, and state specific appeal processes.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EFacilitate resolution to contract violations by leveraging knowledge of Medicare Advantage plans regulatory requirements and Medicare Advantage Appeal processes and requirements.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l1 level1 lfo2;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMaintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact healthcare billing.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3E%26nbsp;%3C/strong%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3EReimbursement-30%%3C/strong%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ESupports Managed Care leadership in contract negotiations through detailed scenario modeling, comparative analysis, and benchmarking.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EEvaluates and understands contractual language as it relates to reimbursement methodologies%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EApplies significant understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and revenue codes%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EDemonstrates proficiency with various reimbursement methodologies including, Per Diem, DRG, fee schedules, and percent of charge%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EDemonstrates extensive knowledge of both commercial and governmental payers for modeling and analyzing contract proposals%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l2 level1 lfo3;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3ERecommends contractual payment term changes that achieve net revenue targets developed by the Regional Managed Care Directors and Contract negotiators.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3E%26nbsp;%3C/strong%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3E%3Cstrong%3ESupport-10%%3C/strong%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l3 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EManages and completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by Leadership%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l3 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EAdapts to new situations and changing priorities to accomplish project deadlines and department goals%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l3 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EMaintains a high degree of accuracy while using large amounts of data%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l3 level1 lfo4;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EApplies technical expertise in the development of analysis, models, and decision support information%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l0 level1 lfo5;tab-stops:list .5in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EDemonstrates excellent data gathering, independent thinking, decision making, problem solving and reporting skills; excellent follow through.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l0 level2 lfo5;tab-stops:list 1.0in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EServes as process and content expert by demonstrating a thorough understanding of reimbursement methodologies and their impact on internal systems and other departments%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l0 level2 lfo5;tab-stops:list 1.0in;%22%3E%3Cspan style=%22font-family:%26quot;Arial%26quot;,sans-serif;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EContributes to the overall completion of the work product in group project situations%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22color:black;mso-list:l0 level2 lfo5;tab-stops:list 1.0in;%22%3E%3Cspan style=%22color:black;font-family:%26quot;Arial%26quot;,sans-serif;font-size:12.0pt;%22%3E%3Cspan style=%22mso-ansi-language:EN-US;mso-bidi-language:AR-SA;mso-fareast-font-family:%26quot;Times New Roman%26quot;;mso-fareast-language:EN-US;%22%3EMaintains and utilizes available resources to ensure work is completed accurately and timely.%3C/span%3E%3C/span%3E%3C/li%3E%3C/ul%3E%3C/li%3E%3C/ul%3E

The expertise and experiences you’ll need to succeed:

• 3 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment, or related field with bachelor’s degree
• 5 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment or Related Field with Associates degree.
• 7 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment or Related Field with High School diploma or equivalent
• The Senior Compliance Analyst role requires extensive knowledge in Managed Care contract interpretation and payment methodologies, billing, and coding for all types of healthcare entities (hospital, physician, ancillaries, etc.).
• Ability to use data systems, and contract management software applications, clinical information and other information generated by numerous sources to identify opportunities to improve contract reimbursement performance or identify compliance issues.
• Proficiency in performing data and contract analytics; ability to effectively apply analytical and quantitative skills in reviewing payer reimbursement performance.
• Effective oral and written communication skills with the ability to articulate complex information in understandable terms to all levels of staff.
• Must have advanced proficiency with Microsoft Excel, Access, Power Point, and Word.
• Must demonstrate an ability and willingness to learn and adapt to a changing reimbursement environment.
• Ability to conduct oneself professionally, maintain confidence, confidentiality and objectivity.
• Must work with minimal supervision and efficiently manage multiple work streams and analyses.

Preferred Qualifications:

• EPIC Credential (EPIC CRED) in Resolute Hospital Billing Expected Reimbursement Contracts Administration preferred and required within three months of employment
• Certified Public Accountant (CPA) Preferred
• Master's Preferred

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