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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: RUSH Corporate Compliance

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (8:00:00 AM - 4:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $34.89 - $56.78 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

Reporting to the Manager of Compliance audit, the Corporate Compliance Regulatory Analyst plays a critical role in ensuring Rush University System for Health (Rush) maintains the highest standards of regulatory compliance across the system. This position is responsible for conducting comprehensive audits to ensure alignment with federal and state regulations as well as Rush’s internal policies. The Analyst collaborates closely with hospital departments and Rush Medical Group (RMG) to identify, analyze, and resolve compliance related issues, minimizing organizational risk and promoting operational integrity. With a high degree of independence, the Analyst manages both individual and team projects, demonstrating exceptional attention to detail and high level of accuracy. The analyst must have knowledge of CMS conditions of participation, conditions of payment, teaching physician guidelines, and false claims. The individual should exemplify the Rush mission, vision and values and act in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

• Associates Degree in Healthcare discipline

• AAPC or AHIMA certification (e.g. CCS, CCS-P, or CPC)

• Three to five years of compliance audit experience

• Ability to interpret and analyze electronic medical records, ancillary reports and third-party payer guidelines.

• Proficiency in Microsoft Office Applications.

• Excellent verbal and written communication skills.

• Experience with Electronic health record

• Ability to communicate effectively with physicians and hospital department leadership.

• Knowledge and understanding of compliance concepts, such as Fraud, Waste and Abuse, CMS Teaching Physician Rules, documentation and coding requirements.

• Demonstrate capacity to work independently in an organized, detailed manner while maintaining a collaborative team environment.

Preferred Job Qualifications:

• Bachelor's degree in Health Information Technology, Healthcare Administration, Nursing or related field.

• CHC

• Epic electronic health record experience

Responsibilities:

1. Design and execute compliance audits of medical record documentation to detect discrepancies, errors, and inconsistencies to mitigate false claims allegations.

2. Perform targeted reviews of documentation and billing to ensure compliance with Medicare Teaching Physician guidelines and conditions of payment.

3. Develop and conduct training sessions for Physicians and Advanced Practice Providers (APPs), to ensure understanding of Medicare documentation guidelines for “incident to” and split/shared regulations, including place of service codes and supervision guidelines.

4. Prepare and present detailed audit reports of findings to the System Manager with recommended corrective actions.

5. Identify, assess and prioritize compliance risk issues and collaborate with interdepartmental teams to address findings and implement corrective actions.

6. Ability to independently analyze large and complex datasets to identify areas of risk for audit review.

7. Monitor Rush’s adherence to federal and state regulations through recurring compliance audits and internal assessments.

8. Possess strong knowledge of documentation and billing regulations, third party payer requirements, and coding standards (ICD-10-CM, CPT/HCPCS) to effectively assess audit criteria and educational initiatives.

9. Maintain a thorough understanding of regulatory standards by engaging in seminars, training programs, and reviewing current regulatory literature.

10. Assist in developing the department’s annual compliance work plan for approval by the System Audit Committee of the Board.

11. Facilitate compliance awareness through educational materials, newsletters and training sessions tailored to various stakeholders.

12. Support updates to compliance manuals, policies, and internal websites to reflect current standards and practices. Participate in additional duties and projects as assigned, contributing to the overall success of the Compliance Program.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Corporate Compliance Regulatory Analyst

**Location** US:IL:Chicago

**Req ID** 23258