DurhamRecruiter Since 2001
the smart solution for Durham jobs

Senior HCS Physician Compliance Analyst - Rex Professional Compliance

Company: UNC Health Care
Location: Rougemont
Posted on: February 24, 2021

Job Description:

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 all compliance activities which could include reviewing internal processes, documents and reports, and ensuring compliance with internal and external regulatory framework. Serves as an expert resource to physicians, coders and reimbursement analysts across UNC Health. May supervise compliance staff.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. Performs billing audits and ensures correct coding and billing compliance. 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. Seeks out and analyzes opportunities to improve and enhance professional compliance in areas such as coding, clinical documentation, charge capture, and EPIC. The auditor should be familiar with clinical documentation and charge capture methodologies.
  • 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. Participates in committee work, workshops and cross functional teams as directed. Viewed as a facilitator or negotiator that can assist in areas of disagreement. Conducts and/or facilitates meetings where information is shared with operational departments concerning new regulations, billing requirements and other compliance activities or other standards. Provides one-on-one and/or group meetings with providers regarding coding/compliance education. Assists with the development and delivery of appropriate compliance training and education across the UNC Health Care System. Serves as an expert resource to physicians, coders and reimbursement analysts. Responds to inquiries on how best to code, document and bill for services provided.
  • Investigations-- 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 action plans.
  • 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.
  • Supervision-- May supervise compliance staff.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) required.
    • If a Bachelor's degree: Three (3) years of experience in business, health care, coding, revenue cycle, legal, regulatory compliance, or a supervisory role in Revenue Cycle or HIM.
    • If an Associate's degree: Seven (7) years of experience in business, health care, coding, revenue cycle, legal, regulatory compliance, or a supervisory role in Revenue Cycle or HIM.
    • If a High School diploma or GED: Eleven (11) years of experience in business, health care, coding, revenue cycle, legal, regulatory compliance, or a supervisory role in Revenue Cycle or HIM.Knowledge/Skills/and Abilities Requirements:
      • Advanced ability to research regulations and understand professional billing and reimbursement methodologies.-
      • Familiar with reference sources and have the ability to navigate and link various sources of regulations and standards.-
      • Advanced understanding of clinical and revenue cycle operations, and demonstrated understanding of the operating environment and how these operations and the demands of productivity interface with regulatory requirements.-
      • Advanced knowledge of the Professional Compliance Program requirements, with ability to understand, demonstrate, and teach professional compliance, billing and coding compliance to others.-
      • Ability to gather evidence, analyze advanced-data and develop recommendations.-
      • Advanced Microsoft Application Proficiency with the ability to use graphs, pivot tables, and formulas, and ability to create Visio flow charts.
      • Advanced presentation skills; must be able to educate physicians, mid-level providers, support staff and administration on medical record documentation requirements as set forth by the Federal Documentation Guidelines as well as other compliance education areas and audit findings.-
      • Ability to transfer technical coding and billing information and knowledge to non-technical users.-

Keywords: UNC Health Care, Durham , Senior HCS Physician Compliance Analyst - Rex Professional Compliance, Healthcare , Rougemont, North Carolina

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Southern Virginia seeking Family Medicine Physician (Physician #634388
Description: Southern Virginia seeking Family Medicine Physician Hospital employed with 6 weeks PTO Loan Repayment up to 200,000 Office
Company: National Health Partners
Location: Danville
Posted on: 02/27/2021

Southern Virginia seeking Hematology / Oncology Physician (Physician #
Description: Hematology/Oncology opening in Danville, Virginia. Southern Virginia seeking Hematology / Oncology Physician Hospital employed with
Company: National Health Partners
Location: Danville
Posted on: 02/27/2021

CVICU RN Cardiac Intensive Care Travel Nurse
Description: Cardiac Intensive Care Unit RN - Nationwide Travel Nurse Assignments Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking (more...)
Company: HealthCare Traveler Jobs
Location: Danville
Posted on: 02/27/2021


Stepdown RN assignment $1,424.88/week
Description: Medely empowers healthcare professionals like you to find assignments where you'll have consistency for a month or more, build relationships, and gain experience
Company: Medely Inc
Location: Danville
Posted on: 02/27/2021

RRT
Description: Our Story: Fusion isn't just a job it's a lifestyle. Our actions are rooted in ensuring everyone we touch has a better life. Here, we don't just work hard and play hard every day we do it with a purpose. (more...)
Company: Fusion Medical Staffing
Location: Danville
Posted on: 02/27/2021

ICU - Nights - Danville , VA - JOB-00451214
Description: FlexCare is a nationwide leader in the staffing of travel nurses and clinicians. With access to thousands of facilities around the country, our mission is to deliver premier travel staffing solutions (more...)
Company: FlexCare Medical Staffing
Location: Danville
Posted on: 02/27/2021

Medical-Surgical RN assignment $2,918.88/week
Description: Medely empowers healthcare professionals like you to find assignments where you'll have consistency for a month or more, build relationships, and gain
Company: Medely Inc
Location: Danville
Posted on: 02/27/2021

Southern Virginia seeking Orthopedic Surgeon (Physician #)
Description: Orthopedics opening in Danville, Virginia. Southern Virginia seeking Orthopedic Surgeon Incredible Income Potential Join a group of 3 Orthopedic
Company: National Health Partners
Location: Danville
Posted on: 02/27/2021

Circulating RN assignment $1,569.60/week
Description: Medely empowers healthcare professionals like you to find assignments where you'll have consistency for a month or more, build
Company: Medely Inc
Location: Danville
Posted on: 02/27/2021

Outpatient Services Lead Clinician, PACT Clinical Manager, PACT Clinician
Description: Outpatient Services Lead Clinician Position 4324 Provides for overall management and supervision of identified Outpatient staff. Develop, implement, and maintain clinically appropriate services designed (more...)
Company: Danville-Pittsylvania Community Services
Location: Danville
Posted on: 02/27/2021

Log In or Create An Account

Get the latest North Carolina jobs by following @recnetNC on Twitter!

Durham RSS job feeds