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Sr. Revenue Cycle Compliance Analyst

Roseville, United States

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Coordinates and analyzes events and transactions for regulatory compliance. Evaluates, monitors, and communicates the corporate compliance program to the organization, its members and affiliates. Partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or corporate entities. Provides analytic support to assigned functional areas. Places emphasis on revenue cycle compliance.

Job Requirements:

Education and Work Experience:

Associate’s Degree or equivalent combination of education/related experience: Required
Bachelor's Degree or equivalent combination of education/related experience: Preferred
Five years’ practical work experience within Revenue Cycle (HIM, PFS or CDM): Preferred

Licenses/Certifications:

One or more of the following: AHIMA: RHIT, RHIA, CCS, CCS-P, CDIP, CHDA AAPC: CPC, COC, CIC, CPB, CPMA HFMA: CRCR HCCA: CHC: Preferred

Essential Functions:

Works alongside revenue cycle compliance leadership, corporate compliance departmental staff, legal counsel and paralegals to determine if the revenue cycle is functioning in accordance with state and federal guidelines. Responds to and evaluates reported revenue cycle compliance concerns. Analyzes issues and assigns appropriate revenue cycle individuals to work cases. Monitors cases and ensures completion. Tracks completion statistics.
Participates in the hotline investigations as they pertain to revenue cycle and helps ensure issues are resolved in an efficient and timely manner.
Performs probe audits at the request of compliance leadership to determine extent of identified compliance concerns across the system. Helps monitor and track regulatory audit statistics such as RAC, TPE, PPR and CERT.
Provides data analysis and support from a variety of sources, including but not limited to: DA2, Power Insight Explorer (PIE), Compliance 360 and MDaudit. Helps with monitoring RevCycle staff completion of required compliance education in HealthStream.
Monitors legislation and regulations involving compliance-related issues, such as patient billing and coding, etc. Communicates the organization's Code of Conduct to all employees, refreshes employees’ knowledge of the Code of Conduct.
Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

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