HCS Compliance Analyst

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The HCS Compliance Analyst will be assigned to support one (1) of the following Departments in the Compliance Program: Hospital Compliance; Physician Compliance; Compliance and Privacy Operations - Audits and Analytics; or Compliance and Privacy Operations - Third Party Risk Management. Under the supervision and direction of Compliance Program leadership, the HCS Compliance Analyst implement the essential elements of UNC Health's systemwide Compliance Program, such as supporting audits, assisting with monitoring of ongoing risks to the organization, training and educating teammates, completing investigations of potential misconduct, and providing such other professional services as directed.

The HCS Compliance Analyst complete assigned tasks independently and also collaborates with teammates across UNC Health as needed to promote compliance with legal and regulatory requirements, as well as UNC Health policies and procedures. In addition, the HCS Compliance Analyst I serve as a resource to teammates across UNC Health. The Analyst is responsible for managing and analyzing financial assistance programs to support patients in need.This role involves evaluating applications for patient assistance, ensuring compliance with policies, and providing insights to improve fund utilization and patient support. The HCS Compliance Analyst will support the evaluation process by determining financial need through comprehensive case management, data analysis, and financial counseling.

Responsibilities:

1.Auditing and Monitoring:Assists in conducting the annual systemwide Compliance Program risk assessment and in preparing the audit and monitoring work plan for each fiscal year. Completes individual audit and monitoring projects outlined in the Compliance Program work plan. Collaborates with teammates from across UNC Health in order to complete individual projects. Obtains and analyzes patient and business specific data in order to evaluate specific risk areas under review. Performs data collection and analysis. Makes recommendations for performance improvement consistent with applicable policies and legal/regulatory requirements. Analyzes audit findings and reports/tracks results for one-on-one or group feedback. Provides one-on-one or group education. Documents findings in accordance with department standards, communicates findings as directed by leadership, and provides an analysis of findings with recommendations.Application Review and Case Management: Review and assess applications for financial assistance to ensure accuracy and compliance with policy and regulatory requirements. Maintain accurate records of fund activity and guide patients through the financial assistance process.

2. Investigations: Supports investigations of actual or potential violations of relevant laws, regulations, and/or UNC Health policies. Conducts EthicsPoint investigations as assigned by Compliance Program leadership. Documents findings in accordance with department standards, communicates findings as directed by leadership, and provides an analysis of findings with recommendations. Works with operational and clinical leaders to implement corrective action plans.

3.Research and Analysis:Research and Analysis: Maintains current and up-to-date understanding of relevant laws, regulations, policies, procedures, standards, and CMS guidance. Identifies and analyzes areas of weakness within the Patient Assistance Fund program and formulates recommendations that enhance operations and compliance. Prepare compressive reports on fund allocation and program effectiveness.

4.Building Relationships: Develops productive working relationships with UNC Health teammates and external stakeholders. Communicates openly and effectively with UNC Health teammates and external stakeholders. Identifies barriers to completing Compliance Program objectives and develops strategies for resolving those challenges. Serves as a resource to physicians, coders, reimbursement analysts, and other teammates. Responds to inquiries about standards and best practices for coding, billing, documentation, and other risk areas.

5.Professional Development: Basic to intermediate understanding of healthcare reimbursement, health system operations, medical staff standards, coding, billing, and documentation, along with experience using electronic health records. Intermediate presentation skills. Ability to translate policy language, billing, and regulatory information and knowledge to non-technical users. Intermediate organizational skills with the ability to manage multiple projects and multiple deadlines in a positive manner. Intermediate proficiency with software applications such as Microsoft 365 with the ability to use graphs, spreadsheets, pivot tables, formulas, Visio flow charts, dashboards, and other analytic tools. Intermediate proficiency with applications required for area of expertise, data extraction, and data analysis. Intermediate data analysis and critical thinking skills. Ability to organize, analyze and interpret data and evidence, communicate findings and make recommendations.

6.Special Projects: Performs special projects as requested or assigned by Compliance Program leadership. Conducts and/or facilitates professional meetings where information is shared with operational departments concerning new policy changes, billing and other compliance activities or standards. Assists with the development and delivery of appropriate compliance training and education across UNC Health. Prepares policies, procedures, tip sheets, and other resources for UNC Health teammates.

Other information:
Education Requirements:
* Associate's or Bachelor's degree in Accounting, Business Administration, Health Administration, Health Information Management, Nursing or related field.
Licensure/Certification Requirements:
* CCS , CCS-P , CPC , CPC-H , RHIA , RHIT. A coding certification (e.g., CPC, CCS-P) is required within 18 months of hire. Compliance Certification preferred.
Professional Experience Requirements:
* If Bachelor's degree, then two (2) years of health care compliance, revenue cycle, nursing, or other directly related experience required.
* If Associate's degree, then four (4) years of health care compliance, revenue cycle, nursing, or other directly related experience required.
Knowledge/Skills/and Abilities Requirements:
* Excellent communication skills and abilities with regard to active listening, interpreting complex information, and presenting materials. Able to clearly express thoughts and ideas and to effectively transfer knowledge to others. Must be able to interview staff to understand operational processes and areas of concern. Written communication is clear, concise and professional.
* Demonstrates a positive attitude and ability to work with groups of teammates. Maintains appropriate professional conduct, appearance and language. Is tactful and respectful in communication. Ability to lead others and serve as a mentor to peers.

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Hospital Compliance

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$31.04 - $44.62 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.