Talent.com
Analyst, Compliance, Privacy & Risk Management

Analyst, Compliance, Privacy & Risk Management

ArchWell HealthNashville, TN, United States
10 days ago
Job type
  • Full-time
Job description

Audit Analyst, Compliance, Privacy & Risk Management

Job Summary :

The Audit Analyst for Compliance, Privacy & Risk Management is responsible for the oversight and management of auditing and monitoring high-risk, problem prone processes, completing compliance risk assessments to ensure compliance with federal / state laws and regulations, and ArchWell Health policies.

Duties / Responsibilities :

  • Adheres to assigned audit schedule and reviews as outlined in the Compliance Workplan
  • Assists with reviewing internal and external inquiries regarding compliance and privacy matters, including government and third-party payor requests.
  • Conducts audits and focused reviews to ensure compliance with company, government, and payor guidelines.
  • Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.
  • Assists with maintaining regular and consistent governance-level reporting and metrics for the Compliance department, including but not limited to dashboards, board reporting, weekly, monthly, and annual compliance & ethics reporting.
  • Maintain a working knowledge of HIPAA, HHS, and CMS regulations.
  • Participate in the planning and scheduling of compliance projects.
  • Research compliance related questions upon request from departments and / or practices.
  • Identify and report potential audit and compliance risks.

Required Skills / Abilities :

  • Knowledge of Medicare and Medicaid documentation and coding rules and guidelines.
  • Must have an understanding and knowledge of national and state laws and regulations
  • Must have excellent verbal and written communication skills.
  • Strong interpersonal skills
  • Strong organizational and planning skills.
  • Demonstrates a high degree of personal integrity and practice ethical standards.
  • Demonstrates proactiveness and ability to work independently and self-directed in managing multiple concurrent projects.
  • Excellent analytical and problem-solving skills.
  • Advanced skills in all MS Office applications (Word, Excel, Outlook, and PowerPoint).
  • Ability to interpret and apply documentation and coding rules and regulations.
  • Ability to demonstrate competence in performing audits, produce reports, formulate remediation or mitigation plans, and conduct follow-up audits.
  • Minimum Qualifications :

  • Equivalent of 5+ years' experience in compliance auditing, clinical chart reviews, medical necessity review / auditing, revenue integrity, and / or health care compliance
  • Experience in compliance and privacy auditing techniques and methods
  • Certified in Healthcare Compliance (CHC) or Certified in Healthcare Privacy Compliance (CHPC) preferred
  • Bachelor's degree in related field preferred
  • Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) preferred
  • At ArchWell Health, we're creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.

    Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We're passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

    ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.

    Create a job alert for this search

    Analyst Risk Management • Nashville, TN, United States

    Related jobs
    • Promoted
    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Data AnnotationFranklin, Tennessee
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago
    • Promoted
    Director of Cybersecurity and Privacy Risk Advisor

    Director of Cybersecurity and Privacy Risk Advisor

    ConfidentialNashville, TN, United States
    Full-time
    Director of Cybersecurity and Privacy Risk Advisor.Prestigious international law firm.The Company is in search of a Director, Cybersecurity and Privacy Risk Advisor to spearhead the advancement of ...Show moreLast updated: 12 days ago
    • Promoted
    Contract Compliance Analyst

    Contract Compliance Analyst

    ComriseNashville, TN, United States
    Full-time
    The Commitment Analyst manages the highly complex process of aligning Company members to appropriate contract tiers.The Commitment Analyst also provides guidance to Company Sourcing personnel and C...Show moreLast updated: 9 days ago
    • Promoted
    Senior Compliance Analyst

    Senior Compliance Analyst

    KY StaffingNashville, TN, US
    Full-time
    Job Summary : This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and / or corporate entities.Provide consultation ...Show moreLast updated: 3 days ago
    • Promoted
    Product Compliance Manager

    Product Compliance Manager

    JobotLa Vergne, TN, US
    Full-time
    This Jobot Job is hosted by : Christian Aviles.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary : $100,000 - $120,000 per year.We’re a global manufac...Show moreLast updated: 30+ days ago
    • Promoted
    Client Services Tech 1

    Client Services Tech 1

    Pace Analytical Services, LLCMount Juliet, TN, United States
    Full-time
    Tuesday through Saturday, 9 : 00 AM - 6 : 00 PM (Mon-Fri : 9am-6pm the first week for training).Are you ready to work making the world a safer, healthier place? Join our mission to continuously move sci...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Director, Corporate Compliance, Risk Management (Remote)

    Senior Director, Corporate Compliance, Risk Management (Remote)

    Remote StaffingNashville, TN, US
    Remote
    Full-time
    Senior Corporate Compliance Director, Risk Management.We are the first publicly-traded biotech or pharmaceutical company to take the form of a public benefit corporation. Our public benefit purpose ...Show moreLast updated: 11 hours ago
    • Promoted
    Remote M&A Integration Manager - AI Trainer ($50-$60 / hour)

    Remote M&A Integration Manager - AI Trainer ($50-$60 / hour)

    Data AnnotationFranklin, Tennessee
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 11 days ago
    • Promoted
    Reimbursement Analyst

    Reimbursement Analyst

    EnableCompFranklin, TN, United States
    Full-time
    EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified. Powered by proprietary algorith...Show moreLast updated: 19 days ago
    • Promoted
    • New!
    Trade Compliance Analyst

    Trade Compliance Analyst

    Infotree Global SolutionsFranklin, TN, US
    Full-time
    Job Schedule : Full Time, On site.Degree Level : Bachelor's Degree, in international trade, accounting, or other related discipline. US Customs Broker's License in good standing with US Customs and Bo...Show moreLast updated: 12 hours ago
    • Promoted
    Remote FinTech Product Analyst - AI Trainer ($50-$60 / hour)

    Remote FinTech Product Analyst - AI Trainer ($50-$60 / hour)

    Data AnnotationFranklin, Tennessee
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago
    • Promoted
    Manager, Privacy

    Manager, Privacy

    ArchWell HealthNashville, TN, United States
    Full-time
    ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members.We deliver best-in-class care at comfortable, accessible neighborhood clinics where sen...Show moreLast updated: 30+ days ago
    • Promoted
    Accounts Receivable Analyst

    Accounts Receivable Analyst

    Vaco by HighspringGallatin, Tennessee, United States
    Permanent
    The AR Analyst is responsible for managing accounts receivable processes, ensuring accurate and timely invoicing, collections, and reconciliations. The ideal candidate has strong analytical skills, ...Show moreLast updated: 30+ days ago
    • Promoted
    Compliance Analyst

    Compliance Analyst

    Nashville StaffingNashville, TN, US
    Full-time +1
    Do you want to join an organization that invests in you as a Compliance Analyst? At HCA Healthcare, you come first.HCA Healthcare has committed up to $300 million in programs to support our incredi...Show moreLast updated: 1 day ago
    • Promoted
    Metals Compliance & Trade Operations Analyst

    Metals Compliance & Trade Operations Analyst

    US Tech Solutions, Inc.Franklin, TN, US
    Temporary
    We are seeking a detail-oriented and analytical professional to join our Customs & Trade Operations team, with a specialized focus on metals compliance—particularly steel, aluminium, and copper.Thi...Show moreLast updated: 23 days ago
    • Promoted
    Business Data Analyst - Business Model Optimization (Health Insurance)

    Business Data Analyst - Business Model Optimization (Health Insurance)

    Alpha FmcUnited States - Tennessee, Tennessee, United States
    Full-time +1
    Business Data Analyst - 3 Month Contract with potential to extend / convert.Location : South Eastern Tennessee.As a Business Data Analyst at Alpha FMC, you will play a key role in bridging the gap bet...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Director, Corporate Compliance, Risk Management (Remote)

    Senior Director, Corporate Compliance, Risk Management (Remote)

    Tennessee StaffingNashville, TN, US
    Remote
    Full-time
    Senior Corporate Compliance Director, Risk Management.We are the first publicly-traded biotech or pharmaceutical company to take the form of a public benefit corporation. Our public benefit purpose ...Show moreLast updated: less than 1 hour ago
    • Promoted
    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Data AnnotationHendersonville, Tennessee
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago