HCS Physician Compliance Analyst - Rex Professional Compliance
Company: UNC Health Care
Location: Snow Camp
Posted on: February 18, 2021
DescriptionBecome part of an inclusive organization with over
30,000 diverse employees, whose mission is to improve the health
and well-being of the unique communities we serve.Responsible for
assisting Compliance management in compliance activities which
could include reviewing internal processes, documents and reports,
and ensuring compliance with internal and external regulatory
framework. Serves as a resource to physicians, coders and
reimbursement analysts across UNC Health.Responsibilities:
- Auditing and Monitoring- Stays current with changing
regulations, policies, procedures, standards and coding guidelines.
The individual effectively identifies and analyzes areas of
weakness, research causes and formulate recommendations that
enhance operations and compliance. Familiarizes self with area
under review, and if necessary, visits department/facility to gain
operational and process knowledge. Researches all relevant
materials including but not limited to regulations, policies,
procedures, and other standards such as CPT coding guidelines and
CMS policies. Assists in preparing annual audit and work plan.
Performs work outlined in work plan. Obtains and analyzes data.
Identifies and evaluates the area under review, identifying and
documenting areas of risk and vulnerability related to
non-compliance. Assists in development of new policies and
procedures and audit tools. Performs E/M and Procedural coding
audits. Analyzes audit findings and reports/tracks results for
one-on-one or group feedback. Provides one-on-one or group
education. Performs billing audits and ensures correct coding and
billing compliance. Assists with RAC audits and review of other
outside requests as directed. Documents audit work and findings in
accordance with department standards. During the audit and
monitoring process, identifies and analyzes areas weaknesses,
research causes, and formulate recommendations back to the
appropriate department. Provides communication of audit findings to
department leadership as directed by management. The auditor should
be familiar with basic clinical documentation and charge capture
- Customer Service- Provides courtesy and friendly service.
Develops productive working relationships with all levels of
management, staff and providers. Identifies and seeks resolution to
barriers. Demonstrates customer service qualities that instill
confidence. Mentors others on how to provide the highest level of
customer service. Effectively follows up and closes all issues
assigned or identifies issues to management with recommendations on
how to proceed. Conducts and/or facilitates meetings where
information is shared with operational departments concerning new
regulations, billing and other compliance activities or other
standards. Assists with the development and delivery of appropriate
compliance training and education across the UNC Health Care
System. Serves as a resource to physicians, coders and
reimbursement analysts. Responds to inquiries on how best to code,
document and bill for that impact professional compliance.
Communicates openly and effectively with team members and
- Investigations- Investigates, questions, gathers data,
integrates and interprets data with the intent to report
information and provide an analysis and recommendation of findings.
Familiarizes self with area under review. Researches and gathers
all relevant materials including but not limited to regulations,
policies, and procedures, coding guidelines, and CMS rules
regulations. Conducts interviews understanding operational
workflows in order to thoroughly assess compliance issues and risk.
Performs data collection and analysis. Documents findings in
accordance with department standards, communicates findings as
directed by management and provides an analysis of findings with
recommendations. Works with departmental leaders on corrective
- Professional Development- Maintains current knowledge of CPT
and ICD coding guidelines as well as CMS policy and regulations.
Reads trade journals articles related to coding and compliance and
shares knowledge with peers and customers.
- Special Projects- Performs special projects as requested by
management as needed or assigned.Requirements:
- Bachelor's degree in Accounting, Business Administration,
Health Administration, Nursing or related field (or equivalent
combination of education, training and experience).
- Coding certification (e.g., CPC, CCS-P) within eighteen (18)
months from date of hire.
- If a Bachelor's degree: No prior experience required.
- If an Associate's degree: Four (4) years of relevant
- If a High School diploma or GED: Eight (8) years of relevant
Keywords: UNC Health Care, Greensboro , HCS Physician Compliance Analyst - Rex Professional Compliance, Healthcare , Snow Camp, North Carolina
Didn't find what you're looking for? Search again!