Senior Compliance Analyst - Institutional Compliance

Senior Compliance Analyst

The Institutional Compliance department at MD Anderson Cancer Center plays a critical role in ensuring adherence to federal, state, and institutional billing and reimbursement regulations. The Billing & Reimbursement Compliance team partners closely with physicians, operational leaders, and departments across the institution to support compliant billing practices, mitigate organizational risk, and promote operational integrity through audits, investigations, education, and continuous improvement initiatives.

This Senior Compliance Analyst role offers the opportunity to work in a highly analytical and collaborative environment, supporting complex compliance audits and investigations that directly impact institutional operations and regulatory readiness. This position is ideal for an experienced compliance professional who can work independently, manage sensitive matters with discretion, and communicate effectively with physicians, leadership, and operational teams.

In this role, you will independently conduct focused and routine billing & reimbursement audits and investigations, including prospective and retrospective reviews of inpatient and outpatient professional documentation and billing practices. You will identify compliance risks, evaluate audit findings, quantify deficiencies, and develop recommendations for corrective action plans and operational improvements.

You will also prepare detailed reports, present findings to physicians and departments, and collaborate with operational teams to ensure appropriate follow-up and resolution. This role requires strong analytical skills, attention to detail, and the ability to interpret and apply complex federal and state billing regulations, CMS guidelines, and institutional policies.

A significant component of this role involves education, training, and collaboration. You will work closely with leadership and compliance colleagues to develop and provide education related to billing and reimbursement compliance, helping promote awareness and alignment across the institution. You may also provide guidance and oversight to Compliance Analysts and Associate Compliance Analysts on assigned audits and investigations.

Success in this role requires strong investigative and communication skills, sound judgment, and the ability to manage multiple priorities in a deadline-driven environment. Experience in healthcare compliance, billing audits, reimbursement regulations, and provider documentation review is highly valued.

MD Anderson offers a comprehensive total rewards package, including paid medical benefits, generous paid time off, retirement plans, and additional benefits, along with opportunities to work on high-impact compliance initiatives within a mission-driven organization dedicated to excellence, integrity, and patient care.

The ideal candidate will have audit and investigation experience and have prior experience with billing coding.

JOB SPECIFIC COMPETENCIES

Audits/Investigations/Special Reviews Independently conducts focused audits and investigations into information sensitive areas of suspected billing & reimbursement non-compliance. Works collaboratively with other departments to obtain required documents and actively researches background information to develop a thorough understanding of the area being audited.

Independently conducts critical prospective and/or retrospective inpatient and outpatient professional documentation audits of the institution's professional billing, identify problems, risk factors, and risk areas regarding compliance with applicable federal and state statutes, regulations, and guidelines set forth by regulatory agencies and third party payors, as well as The University of Texas System and the institution's rules, guidelines, policies, procedures, and compliance plans.

Assists with identifying billing & reimbursement compliance issues to be audited. Prepares audit notifications and makes arrangements for conducting on-site audits, as appropriate.

Effectively identifies and quantifies billing compliance deficiencies and makes recommendations for corrective action plans.

Recommends changes to operational systems/practices in order to maintain compliance.

Effectively evaluates audits and investigation results with appropriate consideration of relevance and accuracy. Formulates conclusions and recommendations based on accumulated audit evidence.

Prepares timely, thorough, clear, and concise written reports of compliance audits and investigations.

Arranges and participates in Audit Findings Discussion Conferences with the billing professional and/or departments/teams to present audit and investigation findings and make recommendations for corrective action. Communicates effectively with physicians and other qualified healthcare professionals, administrative staff, and other workforce members to ensure a successful audit.

Assesses audit responses provided by operational areas to determine appropriateness of the response. Makes recommendations for additional follow-up audits, if required.

Maintains appropriate and complete audit files and auditing databases. Secures, indexes, and archives all documents for storage. Extracts information from databases to prepare various compliance reports.

Provides supervision to Compliance Analysts' and Associate Compliance Analysts' audits and/or investigations as assigned.

Compliance Representative/Education, Training and Outreach Works in close collaboration with the Education & Outreach Manager, and other members of the Billing & Reimbursement Compliance section or Institutional Compliance, to develop and provide education and training on Billing & Reimbursement Compliance requirements to the MD Anderson workforce, either as part of a corrective and preventive action plan, specialized education or routine education or training activities of the Billing & Reimbursement Compliance program.

Works in close collaboration with other Institutional Compliance staff and/or other management teams throughout the institution to ensure program-wide compliance efforts are in alignment with federal, state, and institutional requirements for billing clinical research services, professional services and/or technical services.

Serves on Institutional Compliance Committees, Sub-Committees, and Work Groups as assigned.

General Compliance Program Activities Maintains working knowledge of new rules, regulations, and revisions, as set forth by CMS, the Medicare Administrative Contractor, and other entities regarding billing & reimbursement compliance. Communicates regulatory/policy updates to assist departments in maintaining acceptable billing & reimbursement compliance practices.

Participates in assignments that: (a.) facilitate improvement in billing operational areas; (b.) enhance infrastructure of the Billing & Reimbursement Compliance program; or (c.) improve the quality of services provided by the Institutional Compliance.

Other Duties as Assigned

Performs special projects and/or other duties as assigned.

Education

Required: • Bachelor's Degree

Preferred • Master's Degree

Work Experience

Required: • 6 years of experience in a compliance related field or in research, information technology, cybersecurity, healthcare administration and/or general business as an analyst, auditor, or fraud investigator OR • 4 years of required experience with preferred degree

• May substitute required degree with additional years of related experience on a one-to-one basis

Licenses and Certifications

Preferred (upon hire): • Certified Fraud Examiner (CFE) OR • CHC – Certified Healthcare Compliance

The University of Texas MD Anderson Cancer Center offers excellent benefits, including medical, dental, paid time off, retirement, tuition benefits, educational opportunities, and individual and team recognition. This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment. It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.