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Job ID: 13463
Location: Morrisville, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Safeguards the assets of UNC Health Care by performing hospital related activities to assure compliance with established policies and regulatory/legal requirements. Operational responsibilities include, but are not limited to, planning and carrying out the annual hospital compliance auditing work plan and coordinating compliance activities within the acute hospital environment. Works independently and collaborates with others across UNC Health Care to review internal processes and make necessary recommendations to assure compliance with internal and external regulatory/legal requirements. In addition, this position receives, documents and properly responds to questions about hospital compliance matters, monitors external resources to remain abreast of changing regulations and assesses risks and exposures to UNC Health Care working to mitigate or eliminate those risks.
Clinical background (BSN or RN), prior direct/acute hospital experience; clinical setting, revenue cycle or risk management highly preferred for this role.
This role will work in Morrisville, NC with primary work remotely.
1. Auditing and Monitoring - Assists in preparing annual hospital compliance auditing work plan. Performs work outlined in the work plan collaborating with necessary members from across UNC Health Care and in accordance with established procedures. Obtains and analyzes patient and business specific data. Identifies and evaluates hospital areas under review, identifying and documenting areas of risk and vulnerability related to non-compliance. Makes recommendations for performance improvement consistent with applicable policies and regulatory/legal requirements.
2. Investigations - Receives, documents, investigates and properly responds to questions regarding matters of hospital compliance 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, procedures, coding guidelines, and external 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.
3. Customer Service - Provides courtesy, professional and friendly service. Develops productive working relationships with all levels of management, staff and providers through open and effective communication methods. Identifies and seeks resolution to barriers as they arise. Demonstrates customer service qualities that instill confidence in others. Effectively follows up and closes all issues assigned in a timely manner or identifies issues to management with recommendations on how to proceed. Conducts and/or facilitates professional meetings where information is shared with operational departments concerning new regulations, billing and other compliance activities or standards. Assists with the development and delivery of appropriate compliance training and education across UNC Health Care. Serves as a hospital compliance resource to all staff across the health care system. Adheres to and portrays themselves as a model employee for the UNC Health Care Code of Conduct.
4. Special Projects - Performs special projects as requested by management as needed or assigned.
5. Professional Development - Stays current with changing regulations, policies, procedures, standards and coding guidelines. Maintains a working knowledge of job-specific regulations. Routinely reads health care trade articles related to compliance and shares knowledge with others. Seeks out opportunities to grow professional career.
● Bachelor’s degree in an appropriate discipline.
● Effective July 1, 2016, all new hires must be credentialed in a health care related discipline such as health care compliance or revenue cycle/coding (e.g., CHC, CHRC, RHIA) within 18 months from date of hire.
Professional Experience Requirements:
● Five (5) years of health care compliance, hospital revenue cycle, nursing or other directly related experience.
Knowledge/Skills/and Abilities Requirements:
● Understanding of healthcare reimbursement from payers and basic understanding of hospital, clinical staff, reimbursement, coding, billing and operational department functions, along with experience with hospital information systems including decision support is highly desirable.
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Hospital Compliance
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Morrisville
Exempt From Overtime: Exempt: Yes
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.