This position works in the OHSU Clinical Enterprise Integrity program with duties that span the clinical enterprise at OHSU and partner hospitals. Clinical Enterprise Integrity oversees and manages programs and policies aimed at minimizing regulatory and billing risks to the OHSU healthcare mission.The Clinical Enterprise Integrity program encompasses all of the clinical billing activities at OHSU, as well as regulatory requirements over the operation of the clinical enterprise and the care of patients as related to the regulatory requirements of the federal and state healthcare programs.

The Senior Integrity Analyst position provides compliance support including auditing, monitoring, data analytics for risk assessments and other special projects for OHSU and partner hospitals, including MCMC and HMC. The Senior Analyst plans, organizes and conducts complex data analyses aimed at responding to and monitoring regulatory compliance, providing effective management of healthcare billing and regulatory compliance. This position is an advanced regulatory resource with advanced knowledge of federal, state, local, and OHSU statutes, regulations, guidance, policies, procedures, and systems, and is responsible for process improvement and the accurate and timely management of audits, inspections, projects, issue resolution, and inquiries.

• Bachelors degreeand five or more years of technical or equivalent experience. Additional experience would be consideredin lieu of degree
• Knowledge of the inpatient and outpatient documentation, coding, and billing requirements for professional services
• Familiarity with the highly complex administrative and financial environment at an academic medical center;
• Strong interpersonal skills, with demonstrated success dealing with staff at all levels, including physicians, non-physician practitioners, nurses, management, etc.;
• General understanding of an academic medical center, its structure, and its operations;
• Experience reviewing, interpreting, and providing guidance on regulatory rules and standards;
• Ability to read and comprehend complex medical procedures in order to provide thorough and accurate assessments;
• Advanced proficiency with electronic systems and software.
• Have or obtain within 2 years of hire applicable or related certification, such as CPC or CHC.
• Must be able to perform the essential functions of the position with or without accommodation
  

• Advanced degree or additional emphasis/training/education in healthcare administration, nursing, or other related fields.
• Experience working with coders, billers, physicians, and operational leadership.
• Functional knowledge of current coding and billing requirements
• Advanced knowledge in federal and state laws, regulations, and guidance relating to clinical billing and related areas
• CPC and/or CHC preferred
• Compliance 360 Certified Administrator

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