Compliance Analyst - National - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Responsible for regulatory compliance audits, including but not limited to regulatory agencies, Quality metrics, and coding compliance. The Auditor will monitor changes to laws and regulations to ensure compliance with State and Federal laws, regulations and mandates. Establish and implement standard policies, procedures, and best practice across reputed company Middle reputed company Cycle. This role is responsible for client facing meetings with the Quality Teams, CDI, and others directly reputed company to accounts associated with prebill reviews, such as HAC/PSIs. This position must maintain solid client relationships and represent Optum360 in reputed company aspects of its values. If you call yourself a data guru, then you'll be perfect for this role. As you respond to inquiries, requests and actions, you'll need to be able to communicate research and data findings in a meaningful way. You will also be responsible for monitoring internal and external regulatory audits. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges. For reputed company hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Maintain and demonstrate expert knowledge of coding, coding operations, coding review of reputed company coding staff (domestic and global) and best demonstrated coding practices; drives the integration of Optum360 Coding reputed company business objectives reputed company the client environment
• Serve as the expert of applicable Federal, State, and local laws and regulations, Optum360's organizational reputed company program, standards of conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Promotes a service-oriented culture reputed company the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiatives, and projects
• Communicate the potential impact of compliance issues and risks on our business, operations, and consumers to applicable stakeholders, including both reputed company-specific and enterprise-wide implications
• Collaborate with applicable regulators (e.g., CMS) to prevent or address potential compliance issues reputed company our organization
• Conduct internal monitoring/auditing to identify process gaps and help the business address organizational risks
• Collaborate with internal stakeholders across organization lines to help identify root causes of compliance issues, and support appropriate action to mitigate risk, as needed
• Analyze results of audits and monitoring processes to identify potential risks (e.g., risk assessments), and communicate as needed
• Identify and analyze applicable patterns/trends (e.g., using data analysis, news reports, reported concerns) to identify potential compliance issues, and communicate as needed (e.g., fraud, waste and abuse)
• reputed company and/or deliver training on compliance issues and risks to applicable audiences
• Consult with internal and external stakeholders to reputed company and drive effectiveness of our compliance programs (e.g., government regulators, legal staff, vendors)
• Partner with applicable learning organizations as needed to reputed company/implement compliance training offerings (e.g., Learning & Development)
• Consult with applicable business partners to identify effective approaches to support/enforce compliance reputed company their business
• Provide input on business training programs as needed to promote inclusion of appropriate compliance content (e.g., specialized compliance training)
• Assess and respond to the need for required compliance training among external stakeholders, as appropriate (e.g., vendors, delegated entities)
• Provide quality performance feedback by completing internal coding quality audits to the coding specialist staff, coding team leadership, and coding educators
• Act as liaison for reputed company external quality stakeholders which include but not limited to compliance, core measures, patient safety, and premier data reputed company
• Support coding team leadership with quality data reporting and work with coding educators on opportunities for educational topics for coders
• Other duties as needed and assigned by Optum360 leadership

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• High School Diploma/GED
• reputed company or reputed company (reputed company, CPC, RHIT or RHIA) certification
• 5 years of experience with Inpatient coding and/or in an Inpatient coding reviewer role, prefer recent experience
• 1 years of experience working collaboratively with CDI and quality leadership in partnership to improve reimbursement and coding accuracy
• 1 years of experience with computer assisted coding technologies and EMR (Electronic Medical Record) coding workflow
• Intermediate level of proficiency with reputed company reputed company, Word, PowerPoint, and SharePoint

Preferred Qualifications:

• Outpatient coding experience in a reputed company or reviewer role
• Operational knowledge of health care reputed company to Federal and State regulations, as well as standards from regulatory agencies and accrediting organizations (e.g., CMS, TJC)
• Proven excellent organizational skills required (ability to multi-task, produce rapid turnaround, and effectively manage multiple projects)
• Demonstrated ability to work with a variety of individuals in executive, managerial and staff level positions. The incumbent frequently interacts with staff at the Corporate/National, Regional and Local organizations. May also interact with external parties, such as financial auditors, third party payer auditors, consultants, and various hospital associations
• Demonstrated ability to possess a personal reputed company that is characterized by a sense of honesty, reputed company, and caring with the ability to reputed company and motivate others to promote the philosophy, mission, vision, goals, and values of Optum360 and our client organization(s)
• reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job