Compliance Analyst-RBT

Overview:

Purpose:

This position may also participate in organizational risk analyses or other corporate ethics and compliance-related activities.

Essential Duties & Responsibilities:

• Proactively maintains awareness of laws, regulations, and other external/contractual requirements and performance standards applicable to the company’s operations.
• Collects, analyzes, and summarizes data using Word, Excel, PowerPoint and other tools to prepare informative reports and identify trends.
• Performs internal reviews and audits – including coding and billing audits – and collaborates with internal staff, to ensure billing practices follow company policies and procedures, applicable laws, regulations, contractual requirements, commonly accepted billing practices, and internal quality standards.
• Identifies gaps in, and assists in writing, policies and procedures, risk assessments, and work plans.
• Assists in developing and delivering internal training and communications on laws, regulations, contracts, or compliance and ethics-related topics.
• Identifies opportunities for improvements in business processes and assists with communicating or training staff on improving efficiency, effectiveness, or compliance; tracks trends to determine if improvements are effective.
• Assists the Compliance team in administrative tasks such as organizing, hosting, and facilitating meetings, developing meeting agendas, presentations, and taking meeting minutes.
• Receives, coordinates, evaluates for adequacy, and responds to incoming requests for client information from payor entities in a timely manner.
• Establishes and maintains mutually beneficial working relationships; acts as a liaison for the Compliance department, interfacing with other operational area staff of all levels and all functions.
• Exemplifies BI’s organizational ethics, compliance, and company values.

Duties & Responsibilities:

• As a representative of the Compliance team, the Compliance Analyst goes beyond simply demonstrating ethical and compliant behavior, but strives to be a model for others and an advocate for ethical decision-making and compliant behaviors. Candidates will support BI’s organizational values of: Caring, Accountable, Collaborative, and Family-Focused. Candidates will adhere to all BI’s policies and procedures, Code of Conduct, HIPAA rules, documentation standards, etc.
• Performs Other Duties as Assigned

Requirements:

• Current certification as a Registered Behavior Technician (RBT) from the Behavior Analyst Certification Board (BACB), or attainment of certification within 6 months of hire, and maintained throughout the duration of employment.
• Bachelor’s degree in a medical, healthcare compliance, health administration, or behavioral health-related field.
• Experience with healthcare laws, regulations, contracts, and health insurance/managed care concepts.
• Working knowledge of compliance issues in healthcare and managed care environments, esp. ABA therapy and HIPAA.
• Ability to understand medical and behavioral healthcare information and terminology, including CPT and ICD codes.
• Excellent interpersonal, written, and verbal communication skills to include typing, document formatting, presentation development, hosting one-on-one and in-person meetings.
• Ability to self-prioritize, independently seek information and develop solutions; ability to execute multiple tasks in a fast-paced environment with changing priorities.
• Demonstrated professional integrity and ethical decision making.
• Ability to maintain strict confidentiality in business matters related to clients, families, and co-workers.
• Familiarity with Microsoft Office suite of applications, especially Outlook, Word, PowerPoint, and Excel.
• Detail and accuracy-oriented; analytical and collaborative mindset.
• Preferred Requirements: Prior experience working in a healthcare ethics, compliance, or audit department handling sensitive and confidential company, patient, and employee information; Experience with responsible handling of elevated electronic and physical access.
• Preferred Requirements: Coding specialist certification.
• Preferred Requirements: Experience with a behavioral healthcare provider organization, especially ABA therapy providers.
• Preferred Requirements: Familiarity with the Seven Elements of an Effective Compliance Program.
• Preferred Requirements: 3 years experience in a healthcare or health insurance setting.