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Compliance Analyst
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Compliance Analyst
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Robert Walters San Francisco, United StatesCompliance Analyst · Our client, an established and well-performing investment manager in San Francsico CA, is seeking a Compliance Analyst to join their team. · As a Compliance Analyst, you will play a crucial role in maintaining the integrity of our client's operations. Your ...
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Compliance Analyst
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Larson Maddox San Francisco, United States3 days ago · Be among the first 25 applicants · A Hedge Fund is seeking a · Compliance Professional · with experience working for a registered investment adviser. · This role will report to the General Counsel / Chief Compliance Officer (GC/CCO). · Essential Duties And Respo ...
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Compliance Analyst
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Compliance Analyst
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US Tech Solutions San Francisco, United StatesDuties · : · The Global Complaints team is divided into three units, namely Consumer Complaints, Regulatory Complaints and Litigation Support. Each unit is made up of L2 complaints analysts responsible for production work - they are expected to accurately review and respond to ...
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Compliance Analyst
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Compliance Analyst
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Parafin San Francisco, United StatesJob Description · Job DescriptionAbout Us: · At Parafin, our mission is to grow small businesses. · Small businesses are the backbone of our economy, yet banks do not have their back. Parafin is a technology company that builds infrastructure which enables small businesses to ge ...
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Compliance Analyst
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Living Talent Company San Francisco, United StatesInvestment Management Firm (100B+ AUM) Fulltime Hybrid, 3 days in office in Chicago Loop Full relocation availableBase + Bonus 140k - 160k Robust benefits package Job Details:Code, test, and implement investment compliance rules in Charles River IMS (CRIMS)Interpret investment ag ...
Clinical Senior Compliance Analyst - San Francisco, United States - University of California
Description
Clinical Senior Compliance AnalystClinical Enterprise Comp
Full Time
77954BR
Job Summary
The Clinical Senior Compliance Analyst (i.e.
Clinical Analyst) reports directly to the Associate Director of Revenue Cycle Compliance within the Office of Healthcare Compliance & Privacy (OHCP).
The Clinical Analyst serves as a centralized resource for planning, supporting, and conducting the claims appeal processes related to third party payer and regulatory audits for UCSF Health hospital and professional revenue cycles.
The Clinical Analyst evaluates third party payer and regulatory audit outcomes, proposes corrective actions for risk mitigation and works with compliance leadership to ensure implementation.
The Clinical Analyst conducts coding and billing audits including evaluation of medical necessity and/or compliance with clinical requirements related to reimbursement.
The Clinical Analyst applies extensive clinical knowledge to address regulatory audit findings and denials related to medical necessity and coding/billing, and serves as a clinical subject matter expert for the UCSF Healthcare Compliance Program.
The final salary and offer components are subject to additional approvals based on UC policy.To see the salary range for this position (we recommend that you make a note of the job code and use that to look up): TCS Non-Academic Titles Search
Please note:
An offer will take into consideration the experience of the final candidate AND the current salary level of individuals working at UCSF in a similar role.
For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range.
To learn more about the benefits of working at UCSF, including total compensation, please visit:Department Description
The University of California San Francisco Healthcare Compliance Program is responsible for implementation of an "effective compliance program," consistent with the U.S.
The Program is responsible for the promotion of a comprehensive approach to compliance with health care laws, regulations, and policies across the UCSF healthcare enterprise, which includes a leading academic medical center, outpatient clinics, professional services, and clinical schools.
The Program develops, implements, and enforces University policy related to UCSF clinical operations and supports methods of preventing and detecting inappropriate, improper, and fraudulent conduct in the furnishing of health care services.
Required QualificationsBachelor's degree in healthcare or related field, and / or equivalent combination of experience / training in a hospital or large healthcare system
5 or more years of relevant work experience including a minimum of 5 years progressive experience conducting clinical and/or coding and billing compliance audits for Hospital and/or Professional services
Clinical licensure (e.g., RN - Registered Nurse, NP, PA, MBBS)
Advanced knowledge of Medicare and Medicaid program rules and regulations and experience applying rules and regulations in order to defend medical necessity and coded and billed services in both hospital and professional settings
Strong knowledge and understanding of revenue cycle compliance and regulatory standards across the healthcare industry or in-depth knowledge within a specialty area
Ability to perform regulatory and industry research and apply complex clinical concepts relevant to clinical reimbursement requirements
Advanced organizational and project management skills, with the ability to collaborate with, stakeholders, prioritize tasks, and see projects through from inception to completion on schedule.
Advanced interpersonal skills for collaborating effectively with managers and staff at all levels and across the organization, and with payers as well as representatives of regulatory audit entities.
Skills in coaching and mentoring peersAdvanced skills in written and verbal communications, with the ability to convey highly complex technical information, education, and instructions in a clear and concise manner, and to produce high-quality reports, documentation, presentations, and educational materials
In-depth ability to collaborate effectively with clinicians, senior staff, and management across departments, providing advice and counsel on complex regulatory issues of functionality, efficiency, and program development
Strong analytical and critical thinking skills, with the ability to quickly analyze problems, determine the appropriate level of intervention, and develop and apply effective solutions
Strong knowledge of medical records, medical terminology, principles of ICD-10-CM, ICD-10-PCS, and CPT coding
Strong knowledge of medical and surgical procedures and other healthcare practices and trends
Demonstrated ability to track/trend metrics related to appeal and denial processing
Preferred Qualifications
One or more of the following: RHIA, CCS, CCS-P, CPC, CDIP, CCDS
Experience with coding and billing audit software
Experience with Epic electronic health record system
Experience conducting defense audits and writing formal appeal letters
Experience in an academic and/or trauma level 1 medical center setting
License/Certification
Clinical licensure (e.g., RN - Registered Nurse, NP, PA, MBBS)
About UCSF
The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.
Pride ValuesUCSF is a diverse community made of people with many skills and talents.
We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.
In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce.
We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care.
Additional information about UCSF is available atJoin us to find a rewarding career contributing to improving healthcare worldwide.
Equal Employment Opportunity
The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.
For the University of California's Affirmative Action Policy, please visit:For the University of California's Anti Discrimination Policy, please visit:
Organization
Campus
Job Code and Payroll Title
006531 REGL AND CMPLNC HC SPEC 4
Job Category
Professional (Non-Clinical), Research and Scientific
Bargaining Unit
9- Policy-Covered (No Bargaining Unit)
Employee Class
Career
Percentage
100%
Location
Remote / Telecommute
Shift
Evenings
Shift Length
8 Hours
Additional Shift Details
Monday - Friday; 8AM -5PM PST; Remote Work Model
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