Compliance Analyst - Revenue Cycle

About City of Hope

City of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.

Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope's translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope's specialized cancer expertise.

A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation's "Best Hospitals" in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.

City of Hope's commitment to Diversity, Equity and Inclusion

We believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities. Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding. We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds and perspectives; this is reflected in our work and represented in our people.

Position Summary

Compliance Analysts serve as Compliance Department staff and are key team members in City of Hope's revenue cycle compliance programs and activities. At the direction of a Compliance Manager, Compliance Analysts perform regular and ad hoc audits to monitor compliance with City of Hope's revenue cycle billing and coding requirements, policies and to ensure compliance with federal and state regulations. They are also responsible for fielding and responding to ad hoc billing, coding or compliance-related inquiries including investigations, monitoring and program improvement activities, and using judgment and expert knowledge to escalate issues to the relevant Compliance Manager. Compliance Analysts also assist in reviewing and responding to various compliance related audits. Compliance Analysts track compliance matters and communicate regularly with other departments including Health Information Management Services, Patient Financial Services and Information Security, and also with various levels of staff regarding revenue cycle issues. Bachelor's degree and at least three (3) years' experience in a health care setting required, preferably in a position that required knowledge and experience with the relevant area of subject matter expertise (see attached addenda), or a similar job that required interpretation of complex regulations and communication of same to all levels of staff. Individual must possess excellent attention to detail, strong writing and verbal communications skills, and be able to make critical decisions based on data analysis.

Key Responsibilities include:

• Performs regular and ad hoc internal audits or provides support for external audits as directed within established timeframes.
• At the direction of the Compliance Manager, conducts routine internal incident investigations and follow up.
• At the direction of the Compliance Manager, acts as a resource for compliance inquiries, including receipt, evaluation and follow up. Gathers information and data needed to make decisions and provide advice.
• Supports compliance committee and assists with special projects relating to the area of expertise (see addenda) as requested. Assists with projects involving data management using database tools.
• Develops and maintains departmental policies and procedures.
• Maintains current knowledge of application of federal and state laws and regulations relevant to area of expertise (see addenda), and enhances professional growth and development by participating in educational programs relating to such topics.
• Supports the Corporate Compliance Office with performance of other compliance-related duties as requested.
• Familiarity with hospital philosophy and its concept of care.
• Ability to deal with a variety of personalities and situations and excellent verbal and written communication skills.

Basic education, experience and skills required for consideration:

• Bachelor's degree.Experience may substitute for minimum education requirements.
• At least three (3) years experience in compliance, preferably in a healthcare setting; Excel; Access
• Microsoft Outlook, Word, PowerPoint and Excel and Adobe Acrobat Writer and Reader, experience with Fairwarning an asset

Required Certification/Licensure:

• Certification in Healthcare Compliance

Preferred education experience and skills:

• Master's or other graduate degree
• Data management and Governance Risk and Compliance (GRC) Tools

Additional Information:

• As a condition of employment, City of Hope requires staff to comply with all state and federal vaccination mandates.

City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.