Compliance Analyst II

• 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

• 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

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