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Compliance Analyst


Summary

Job Description

POSITION SUMMARY: The Compliance Analyst is responsible for supporting the Penn Medicine Lancaster General Health VP of Risk Management and Corporate Compliance, Compliance Director/Manager and/or designee in reviewing, promoting and evaluating regulatory and other compliance related issues throughout Lancaster General Health.  The Compliance Analyst works in accordance with the LG Health Compliance Program.  The Compliance Analyst is able to respond to and determine compliance with a multitude of external forces influencing the entire enterprise, including Health Reform regulation, CMS rules and regulations, State regulations and commercial payer requirements.  The Compliance Analyst serves as a role model for compliant and ethical behavior consistent with the mission, vision and values of LG Health.

LOCATION: Lancaster, PA

HOURS: Full time (40 Hours per Week), Hybrid remote, This position supports corporate services with its main focus on non-billing compliance rules and regulations.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Implement Compliance Department initiatives such as the annual Conflict of Interest Disclosure project and Exclusion/sanction checking, Accountable Care Organization (ACO) training and education, and other compliance related education and training promoting system wide understanding of compliance,
  • Monitor federal, state, and other regulations and guidelines, trade publications, code changes and analyze potential risk to the enterprise,
  • Identify risk areas or areas of vulnerability within the organization, determine root cause(s), suggest solutions, analyze data, and perform risk assessments,
  • Raise issues and concerns to the LG Health Compliance Director, their designee or other appropriate resource to validate and remediate problems,
  • Perform research-presenting findings in a timely well-organized fashion,
  • Follow Compliance Department protocols and annual work plan, perform audits and reviews on regulatory issues; may perform documentation, coding and billing audits as requested by management.
  • Prepare audit reports for Executive Management according to Compliance Department protocols that highlight deficiencies and recommend corrective actions,
  • Pursue problems or potential problems until full resolution with direction from PM Lancaster General Health Compliance Department,
  • Evaluate adherence to policies and procedures with respect to compliance and regulatory rules

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Serves as an organizational role model for compliant and ethical behavior
  • Demonstrates technical/professional expertise and understanding related to elements of the compliance role
  • Coordinates interdepartmental and intradepartmental team approaches to review findings, and performs other duties as assigned

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • Bachelor’s degree required, preferably in healthcare related field such as Health Information Management, Health Administration, Nursing, or proof of equivalent work related experience
  • Must hold current coding certificate such as: Registered Health Information Administrator (RHIA), Hospital Coding Certificate (CCS), other coding certificates (e.g. RHIT, CCS-P, CPC, CPC-H COC, CPMA)
  • Two (2) or more years of practical experience in health care regulation
  • Extensive knowledge of various coding and reimbursement systems and coding experience
  • Knowledge of rules and regulations pertaining to federally funded programs (e.g. Medicare and Medicaid) along with knowledge of documentation requirements for coding and billing
  • Ability to affect change while maintaining positive relationships,
  • Highly developed analytical and organizational skills; excellent written and verbal communication skills and the ability to articulate difficult concepts in an understandable manner
  • Ability to prioritize work and self-manage
  • Ability to navigate through difficult situations
  • Ability to identify primary sources while performing internet research
  • Knowledge of Microsoft Word, Excel, Power Point and Outlook

PREFERRED QUALIFICATIONS:

  • Bachelor’s Degree preferably in Health Information Management, Health Administration
  • 3+ years of coding experience

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely.

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Benefits At A Glance:

PENN MEDICINE LANCASTER GENERAL HEALTH offers the following benefits to employees:

  • 100% Tuition Assistance at The Pennsylvania College of Health Sciences
  • Paid Time Off and Paid Holidays
  • Shift, Weekend and On-Call Differentials
  • Health, Dental and Vision Coverage
  • Short-Term and Long-Term Disability
  • Retirement Savings Account with Company Matching
  • Child Care Subsidies
  • Onsite Gym and Fitness Classes

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

MILL Full Time Posted on 03/29/2022