Talent.com
Compliance Partner-Clinical & Medical Services

Compliance Partner-Clinical & Medical Services

BrightlitalentIndianapolis, IN, US
Hace 24 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Compliance Partner

Join our dedicated team as a Compliance Partner, where you will play a crucial role in ensuring adherence to compliance policies across our regions and service lines. This role supports day-to-day compliance functions, including the development and delivery of compliance training, conducting investigations, analyzing compliance data, ensuring regulatory conformance, and monitoring corrective action plans. This role places a strong emphasis on medical billing accuracy, healthcare claims auditing, and regulatory documentation compliance.

The Compliance Partner is responsible for the effective implementation and coordination of compliance policies within assigned regions or service lines, serving as the primary resource for corporate compliance matters. This position promotes a culture of integrity, regulatory accountability, and continuous improvement in healthcare compliance.

This position offers

  • Employee Assistance Program 24 / 7 counseling services, legal assistance, & financial consultation for you and your household at no cost
  • Mileage Reimbursement Company paid for work functions requiring travel
  • Employee Discounts Hotels, Theme Parks & Attractions, College Tuition
  • Workplace Culture - An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting a healthy, joyful workforce
  • Additional Perks & Benefits - Scroll down to bottom of this post to learn more

Essential Job Functions

Compliance Program Management

  • Implement and monitor regional compliance activities in alignment with federal, state, and accreditation standards (e.g., CMS, OIG, CARF, HIPAA, 42 CFR Part 2).
  • Identify risk trends, monitor for policy non-conformance, and develop mitigation strategies in collaboration with leadership.
  • Participate in development and review of policies, procedures, and compliance initiatives across service lines.
  • Compliance Training & Education

  • Develop and coordinate corporate compliance training tailored to high-risk roles, including billing, coding, and clinical documentation.
  • Track training metrics, ensure annual attestations, and assist team members in understanding the Code of Conduct and non-retaliation policies.
  • Educate team members on compliance with hotline use and mandatory reporting obligations.
  • Investigations & Auditing

  • Conduct investigations of compliance concerns, including billing errors, coding discrepancies, and potential fraud, waste, or abuse.
  • Prepare detailed, objective investigative reports citing applicable regulatory guidance.
  • Lead and / or support focused internal audits of claims and documentation for billing integrity.
  • Medical Claims Monitoring

  • Perform regular review of clinical documentation, encounter notes, and medical claims for accuracy, coding compliance (CPT, HCPCS, ICD-10), and timeliness.
  • Coordinate with billing teams, clinical providers, and coders to correct and prevent future errors.
  • Provide feedback, identify trends, and make recommendations for improved billing practices.
  • Collaboration & Reporting

  • Partner with HR and leadership on disciplinary action, training compliance, and mitigation follow-through.
  • Regularly report findings, outcomes, and metrics to the Vice President of Compliance Culture.
  • Attend team meetings, team member events, and engage with employees across locations to support compliance visibility and awareness.
  • Other duties as assigned.
  • Knowledge, Skills, and Abilities

  • Extensive knowledge of healthcare regulations, coding, and billing standards (CMS, Medicaid, CARF, HIPAA, 42 CFR Part 2).
  • Strong understanding of clinical documentation integrity and audit standards.
  • Exceptional verbal and written communication skills.
  • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) and Electronic Health Record (EHR) systems.
  • Strong analytical, problem-solving, and investigative skills.
  • Ability to manage multiple priorities, meet deadlines, and maintain confidentiality.
  • Ability to travel to various locations, including occasional overnight travel.
  • Experience and Education Qualifications

  • Bachelor's degree in health administration, nursing, health information management, or a related field required.
  • Three years of experience auditing medical claims, billing processes, or health plan compliance required.
  • Medical coding certification preferred such as one or more of the following :
  • Certified Professional Coder (CPC) AAPC
  • Certified Coding Specialist (CCS) AHIMA
  • Certified Professional Medical Auditor (CPMA) AAPC (preferred)
  • Licensed Practical Nurse (LPN) preferred for BMG billing processes.
  • Experience with compliance investigations and / or healthcare compliance program implementation strongly preferred.
  • Experience in behavioral health or substance use disorder services is a plus.
  • Employment Requirements

  • Successful completion of background check including criminal record, driving record, abuse / neglect, and fingerprint check.
  • Completion of New Hire Orientation at the beginning of employment.
  • All training requirements including Relias at the beginning of employment and annually thereafter.
  • Current driver's license, acceptable driving record and current auto insurance.
  • Physical Requirements

    ADA Consideration - Sedentary work : Exerting up to 10 pounds of force occasionally (exists up the 1 / 3 of the time) and / or a negligible amount of force frequently (exists 1 / 3 to 2 / 3 of the time) to lift, carry, push, or pull, or otherwise move objects, including the human body. Repetitive movements of hands, fingers, and arms for typing and / or writing during work shift. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

    Keywords : Compliance, Compliance Partner, Corporate Compliance, Training, Investigations, Risk Management, Healthcare Compliance, Regulatory Standards, Integrity, Policy Implementation

    Position Perks & Benefits :

  • Paid time off : full-time employees receive an attractive time off package to balance your work and personal life
  • Employee benefits package : full-time employees receive health, dental, vision, retirement, life, & more
  • Top-notch training : initial, ongoing, comprehensive, and supportive
  • Career mobility : advancement opportunities / promoting from within
  • Welcoming, warm, supportive : a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness
  • Brightli is on a Mission : A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

    As a behavioral and community mental health provider, we prioritize fostering a culture of belonging and connection within our workforce. We encourage applications from individuals with varied backgrounds and experiences, as we believe that a rich tapestry of perspectives strengthens our mission. If you are passionate about empowering local communities and creating an environment where everyone feels valued and supported, we invite you to join our mission-driven organization dedicated to cultivating an authentic workplace.

    We are an Equal Employment Opportunity Employer. Brightli is a Smoke and Tobacco Free Workplace.

    Crear una alerta de empleo para esta búsqueda

    Medical Compliance • Indianapolis, IN, US

    Ofertas relacionadas
    • Oferta promocionada
    • Nueva oferta
    Healthcare Quality Reviewer - developmental disabilities field (Columbus)

    Healthcare Quality Reviewer - developmental disabilities field (Columbus)

    Liberty Healthcare CorporationColumbus, IN, US
    A tiempo completo +1
    Health and human services professionals are encouraged to consider an outstanding career opportunity with Liberty Healthcare Corporation. Liberty Healthcare helps ensure people with intellectual and...Mostrar másÚltima actualización: hace 1 hora
    Claims Auditing Specialist

    Claims Auditing Specialist

    Unified Group Services IncAnderson, IN, USA
    A tiempo completo
    Quick Apply
    Unified Group Services is a full-service third party administrator (TPA) for self-insured group health plans.We're dedicated to providing excellent customer service and the flexibility our customer...Mostrar másÚltima actualización: hace 27 días
    • Oferta promocionada
    Entry Level Insurance Sales - 4 Day Work Week

    Entry Level Insurance Sales - 4 Day Work Week

    Platinum Supplemental InsuranceAnderson, Indiana
    A tiempo completo
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Insurance Sales Representative - Completed Training Required

    Insurance Sales Representative - Completed Training Required

    Platinum Supplemental InsuranceColumbus, Indiana
    A tiempo completo
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    • Nueva oferta
    Regulatory Affairs Specialist (Indianapolis)

    Regulatory Affairs Specialist (Indianapolis)

    Intersurgical, Inc. USAIndianapolis, IN, US
    A tiempo parcial
    We partner with providers, manufacturers and other organizations to supply innovative airway and medical devices that impact the lives of patients every day. Driven by our commitment to supply high ...Mostrar másÚltima actualización: hace 1 hora
    • Oferta promocionada
    Regulatory Affairs Intern

    Regulatory Affairs Intern

    Bristol Myers SquibbIndianapolis, IN, US
    A tiempo completo +1
    The Regulatory Affairs Intern will support the Regulatory Affairs team in preparing documentation, tracking submissions, and assisting with project coordination. This internship offers exposure to r...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    • Nueva oferta
    Health Risk Assessments - Nurse Practitioner (NP) and Physician Assistants (PA)

    Health Risk Assessments - Nurse Practitioner (NP) and Physician Assistants (PA)

    National RecruitersIndianapolis, IN, United States
    A tiempo completo
    Flexible PRN Opportunity for Nurse Practitioners & Physician Assistants - Health Risk Assessments.We're looking for Nurse Practitioners (NPs) and Physician Assistants (PAs) interested in a flexible...Mostrar másÚltima actualización: hace 7 horas
    • Oferta promocionada
    NERC Compliance Specialist

    NERC Compliance Specialist

    Wabash Valley Power AllianceIndianapolis, IN, US
    A tiempo completo
    Headquartered in Indianapolis, Indiana, Wabash Valley Power is a not-for-profit electric cooperative and wholesale provider of reliable, affordable electricity to our 21 electric distribution membe...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Audit Senior - Healthcare

    Audit Senior - Healthcare

    Blue & Co.Indianapolis, IN, US
    A tiempo completo
    LLC is a dynamic and innovative CPA and Advisory firm that provides growth-committed entrepreneurial clients with accounting and consulting services across multiple industries.We are currently seek...Mostrar másÚltima actualización: hace 12 días
    • Oferta promocionada
    Compliance Specialist I

    Compliance Specialist I

    Tech DigitalIndianapolis, IN, US
    A tiempo completo
    Location : Indianapolis, Indiana.We are looking for an ES Compliance Associate to be part of the ES Compliance team! This team is part of the company's first line of defense.In addition to monitorin...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Epidemiologist

    Epidemiologist

    TradeJobsWorkForce46104 Arlington, IN, US
    A tiempo completo
    Plan and direct studies of public health problems to find ways to prevent and treat them if they arise Collect and analyze data—through observations, interviews, and surveys, and by using samples o...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Validation Specialist II

    Validation Specialist II

    PACIVIndianapolis, IN, US
    A tiempo completo
    We are seeking a detail-oriented and proactive.This role is responsible for executing and managing periodic reviews of computer systems, and driving resulting action items to completion.The ideal c...Mostrar másÚltima actualización: hace 4 días
    • Oferta promocionada
    AES Indiana Regulatory Analyst

    AES Indiana Regulatory Analyst

    AESIndianapolis, IN, US
    A tiempo completo
    Are you ready to be part of a company that's not just talking about the future, but actively shaping it? Join The AES Corporation (NYSE : AES), a Fortune 500 company that's leading the charge in the...Mostrar másÚltima actualización: hace 18 días
    • Oferta promocionada
    • Nueva oferta
    Regulatory Affairs Specialist

    Regulatory Affairs Specialist

    Intersurgical, Inc. USAIndianapolis, Indiana, United States
    A tiempo completo
    We partner with providers, manufacturers and other organizations to supply innovative airway and medical devices that impact the lives of patients every day. Driven by our commitment to supply high ...Mostrar másÚltima actualización: hace 1 hora
    • Oferta promocionada
    Outside Insurance Sales - 4 Day Work Week

    Outside Insurance Sales - 4 Day Work Week

    Platinum Supplemental InsuranceAnderson, Indiana
    A tiempo completo
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    • Nueva oferta
    Healthcare Quality Reviewer - developmental disabilities field

    Healthcare Quality Reviewer - developmental disabilities field

    Liberty Healthcare CorporationColumbus, Indiana, United States
    A tiempo completo
    Health and human services professionals are encouraged to consider an outstanding career opportunity with Liberty Healthcare Corporation. Liberty Healthcare helps ensure people with intellectual and...Mostrar másÚltima actualización: hace 1 hora
    • Oferta promocionada
    Compliance Analyst, Responsible Gaming

    Compliance Analyst, Responsible Gaming

    BetMGMIndianapolis, Indiana, United States
    A tiempo completo
    We are revolutionizing sports betting and online gaming in the United States.We are a partnership between two powerhouse organizations-MGM Resorts International and Entain Group.You know our name t...Mostrar másÚltima actualización: hace 1 día
    • Oferta promocionada
    HSE Permit Writer

    HSE Permit Writer

    Eli LillyLebanon, IN, US
    A tiempo completo
    Health Safety And Environment (HSE) Permit Writer.At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indiana...Mostrar másÚltima actualización: hace 12 días