Compliance Associate II - Billing Audits & Investigations, Full-time, DaysChicago, Illinois Job REQID 0058320 Job Function Compliance/Legal/InternalAudit Shift Day Job (1st) Apply Now
The Compliance Associate IIreflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The Compliance Coordinator assists the department managers and directors in the implementation of all aspects of the NMHC Corporate Compliance Program.
- 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. Respond to queries or allegations and triage issues to appropriate departments when necessary (i.e., Human Resources Compliance).
- 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 by monitoring various resources to assess regulatory changes and determine organizational impact.
- 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, when necessary, investigations (in conjunction with the Corporate Compliance Manager) in response to CMS, OIG, and/or other regulatory concerns that emerge throughout the year.
- 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 of dashboards, written reports, or other deliverables to be presented to the department, VP Integrity, Senior Leadership, and/or the Audit Committee.
- Support and assist the Corporate Compliance Manager in identifying and assessing areas of compliance risk for NMHC
- Assist with the development and implementation of the department’s 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.
Required: Bachelors 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 is required.
Preferred: Certified Healthcare Compliance (“CHC”) certification preferred. CPC, RHIA or similar credential strongly preferred. JD, MBA or similar degree preferred. Healthcare compliance experience preferred.
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