Job Description

Audit & Compliance Analyst
Job Number: 20-05151
 
Be at the forefront of healthcare solutions. Eclaro’s client is looking for a Audit & Compliance Analyst in Denver, CO.
 
Eclaro’s client is a large healthcare provider, recognized for clinical excellence and patient-centered care. If you’re up to the challenge, then take a chance at this rewarding opportunity!
 
Responsibilities:
  • This position reports to the Senior Manager and will apply their experience with investigations, audits, and/or consulting projects to identify and evaluate compliance and regulatory risks associated with potential non-compliance with Company policies, procedures, and practices.
  • Generally, this position assists in the execution of the day-to-day compliance program for our dialysis business unit, specifically the Information Technology (IT), Clinical Enterprise, and Revenue Operations departments.
  • The position, amongst other responsibilities outlined below, will investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems.
  • The job responsibilities of Audit & Compliance Analyst include, but are not limited to the following, with a goal of mitigating risk related to the False Claims Act and other state and federal regulations:
  • Investigate potential compliance issues linked to clinical and billing activities, including clinical IT systems;
  • Conduct IT system investigations and audits including performing risk assessment, scoping investigation/audit, developing investigation/audit work plans, performing investigation/audit procedures, documenting work, reporting findings, and developing and implementing appropriate remediation;
  • Perform proactive process and control assessments of policies, procedures and clinical IT systems;
  • Define and understand potential compliance issues, collect and analyze large amounts of data, perform research, identify root causes of potential issues, and evaluate risk to make timely and appropriate decisions;
  • Utilize Excel, Access, and other tools to perform qualitative and quantitative analyses on large amounts of clinical and billing data and develop presentations to communicate the results of such analyses to compliance and operations management;
  • Conduct multiple projects concurrently while managing timelines with their manager and internal customers and assist their manager with projects related to the overall compliance audit and monitoring Programs;
  • Draft written presentations to compliance and operations management to inform decision making; and no direct reports
 
Required Qualifications:
  • Bachelor's degree required;
  • Minimum of 3 years' experience as an investigative, audit, compliance, or legal professional responsible for compliance investigations, external/internal audits, and consulting projects (e.g., process and control assessments);
  • Required experience working with Fee for Service claims and respective electronic health record and billing IT systems;
  • Strong organizational and project management skills with demonstrated attention to detail;
  • Experience in positively and successfully managing relationships with a high energy and diverse group of internal customers across organizational lines;
  • Advanced technology skills including Excel, PowerPoint, and Access including experience with using these tools to create data analytics (e.g., Pivot Table, Vlookup, etc.);
  • A thoughtful, articulate and effective critical thinker and communicator who can distill and articulate the important aspects of any issue;
  • Superior written and verbal communication skills (including presentations) and the ability to drive execution in a team environment;
  • Must be self-motivated, team player with proven ability to identify issues, manage priorities, and deliver on commitments in a fast paced environment; and
  • Hands on, efficient and proven ability to "Get Stuff Done with a bias for action and a strong sense of ownership
 
Preferred Qualifications:
  • JD/CPA/CIA/MBA or other relevant advanced degree or certification
  • Certificate in Healthcare Compliance
  • Experience working for Big 4 or mid-sized audit firms, other consulting firms, or a healthcare company;
  • Experience in healthcare industry dealing with federal healthcare program laws, specifically the False Claims Act;
  • Experience working with Fee for Service regulations including CMS Conditions for Coverage (CfC), Conditions for Participation (CfP), and other CMS Manuals;
 
If interested, you may contact:
Merly Villanueva 
merly.villanueva@eclaro.com
6467559379
Merly Villanueva | LinkedIn
 
Equal Opportunity Employer:
 Eclaro values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. 

Application Instructions

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