In this role, you will be responsible for reviewing escalated alerts at a high volume to identify true matches including: the results of periodic systematic accountholder screenings with PEP, sanctions and negative media, real-time review of online transactions and the review of specific issues escalated from business units
In this role, you will be responsible for providing expert professional quality assurance on charge capture, billing and coding of OB/GYN services along with the appropriate education of administration, clinic staff and billing staff to ensure that divisional revenues are maximized and that all regulatory standards are met.
The Compliance Auditor is responsible for monitoring and maintaining the organization's contractual compliance with its customers. The Auditor also monitors conformance to internal policies and processes.
The Audit and Risk Assessment Analyst partners with IT groups, business groups, and project teams to perform security risk analysis and compliance assessments for applications, infrastructure, and vendor / third parties.
This position will report directly to the Manager of the Regulatory Counsel/Policies & Procedures Group and will interact closely with the Compliance Counsel and other members of the Senior Management Team.
In this role, you will manage comprehensive internal export controls to ensure compliance with US and foreign regulations (ITAR and EAR) in the conduct of international marketing, sales, supply chain and other business activities.
The selected candidate will identifies technical implementation risks related to vendor applications, infrastructure products and legacy system initiatives; and, analyzes potential security exposures and impact to existing software and infrastructure design.
In this role, the selected candidate will review clinical documentation, coding and hospital or professional fee claim or charge information in accordance with the Prospective Reimbursement Analysis (PRA) to determine if the items and services provided to patients enrolled in clinical research studies are to be billed to Medicare, other third party payers or research study accounts.
In this role, the selected candidate will be managing the firms investment compliance program, including on-boarding of new mandates, assessing and resolving issues, and overseeing guideline monitoring.
The Compliance Auditor is empowered to influence changes to policies and processes based on observations derived from audit results. Core skills for the position include: excellent communication and time management skills, attention to detail, and problem resolution.