Compliance Analyst

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ACU-Serve

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

⚕️ Seguro de Saúde

💳 Fintech

☁️ SaaS

Healthcare Insurance • Fintech • SaaS

A ACU-Serve é uma empresa especializada na otimização dos ciclos de receita para prestadores de serviços de saúde, particularmente nos setores de EHM (Equipamentos Médicos para o Lar) e EMH (Equipamentos Médicos Duráveis). Eles se concentram em aumentar as reivindicações limpas através de parcerias estratégicas, soluções inovadoras e tecnologia avançada. A abordagem abrangente da ACU-Serve inclui gestão de ciclo de receita, serviços de cobrança de contas a receber e reabastecimento para farmácia de infusão e serviços de reabilitação complexa, garantindo pagamentos rápidos e precisos enquanto melhora a educação do cliente e a eficiência operacional.

Descrição

• Monitor compliance with applicable laws and regulations, including CMS, Medicare, Medicaid, HIPAA, OIG guidance, and payer-specific billing requirements for DME and Home Infusion • Track regulatory and payer updates and assist with updating internal policies, procedures, and guidance • Collaborate with billing and coding teams to resolve compliance-related issues • Perform routine and focused compliance audits of third-party vendors, documentation, and internal operations workflows • Identify trends, risks, and compliance gaps and assist in developing corrective action plans • Track and validate remediation efforts to ensure ongoing compliance • Assist with compliance training and education related to ACU-Serve’s corporate compliance requirements and initiatives • Communicate audit findings and regulatory updates in a clear, actionable manner • Prepare audit summaries, compliance reports, and tracking logs • Support responses to HITRUST audits, customer compliance issues, and compliance-related documentation requests • Maintain accurate and organized compliance records

🎯 Requisitos

• Bachelor’s degree in Healthcare Administration, Compliance, Business, or a related field, or equivalent relevant experience • 2+ years of relevant experience in healthcare billing, compliance, auditing, or revenue cycle management • Knowledge of Medicare, Medicaid, and commercial payer billing requirements • Ability to work independently in a remote environment and manage competing priorities • Strong attention to detail and analytical skills • Experience in a third-party billing or revenue cycle management organization • Hands-on experience with DME and/or Home Infusion billing • Exposure to OCR audits, HITRUST certification requirements, or compliance investigations • Clear written and verbal communication skills • Strong organizational and time management abilities • Problem-solving and critical-thinking skills • High ethical standards and commitment to confidentiality • Proficiency with billing platforms, EHRs, and Microsoft Office (Excel required)

🏖️ Benefícios

• Professional certifications such as CHC, CHPC, CPC, CCS, or similar • Familiarity with HIPAA privacy and security requirements in a remote work setting