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Penn Medicine Lancaster General Health
Location: Lancaster, Pennsylvania
Work Setting: Hospital
Job Function: Compliance
Job Type: Full-Time
Overview – Compliance Analyst
At Lancaster General Health, our culture is what sets us apart and creates a lasting impression of our health system in the community and in the hearts of our patients and their families. A role with us is more than just a job, we ask that you Live Your Legacy at LGH by finding your passion in your everyday role, committing to those you serve, and reaching for your personal best.
PENN MEDICINE LANCASTER GENERAL HEALTH, a member of the University of Pennsylvania Health System (Penn Medicine), is a not-for-profit health system with a comprehensive network of care encompassing Lancaster General Hospital (LGH), Women & Babies Hospital and the Lancaster Rehabilitation Hospital (a partnership with Kindred Healthcare). We are an Accredited Trauma Center-Level I through the Pennsylvania Trauma Systems Foundation with over 800 Licensed beds. Our membership in Penn Medicine brings together the strengths of a world-renowned, not-for-profit academic medical center and a nationally recognized, not-for-profit community healthcare system.
We are recognized as 1 of only 9 hospitals in the entire country with awards in Medicare.Gov, LEAPFROG and Healthgrades Americas 50 Best Hospitals. We have attained four year Magnet ® recognition status for the fourth time with the American Nurses’ Credentialing Center (ANCC) and we are the 2018 recipient of the Foster G. McGaw Prize in recognition of the commitment to community service.
Join us and be part of a team that empowers you to do more than your job and encourages you to: Live Your Passion. Live Your Best. Live Your Commitment. Live Your Legacy.
PENN MEDICINE LGHP offers a comprehensive benefits package:
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program so that our employees can stay actively engaged and committed to living their legacy every day. Together, we will continue to make medical advances that help people live longer, healthier lives.
PENN MEDICINE LANCASTER GENERAL HEALTH combines a Nationally Ranked Hospital with great schools, safe neighborhoods, affordable housing, local community events and festivals as well as a wealth of cultural and recreational activities. The scenic Susquehanna River Valley provides opportunities for fishing, skiing, kayaking, hiking and mountain biking in addition to easy access to NJ shoreline or Delaware beaches. Urban life is easily accessible, with New York, Baltimore, Philadelphia and Washington D.C. a train ride away. Local universities, Fulton Theatre, the downtown shopping and dining district, and local sports teams make Lancaster a great place to Live, Work and Play.
SUMMARY: The Compliance Analyst is responsible for supporting the Compliance Officer, Compliance 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 consist with the mission, vision and values of LG Health.
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 Compliance Manager, 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; perform inpatient, outpatient and professional coding and billing audits,
• 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 Compliance Department Management,
• Assist in policy and procedure development,
• Evaluate adherence to policies and procedures with respect to coding, billing, and other areas of compliance and regulatory rules,
• Identify patterns in denials working with appropriate parties to correct errors and mitigate future errors,
• Participate in external audits from the Center of Medicare and Medicaid Services (CMS), Recovery Audit Contractors (RAC) and Medicare Administrative Contractor (MAC), Office of Inspector General (OIG) and Department of Justice (DOJ).
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 the technical and/or professional expertise and understanding of the elements of the job.
• Coordinates interdepartmental and intradepartmental team approaches to review findings.
• Performs other duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS:
• Bachelor’s degree, 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.
• Highly developed analytical and organizational skills; excellent written and verbal communication skills and the ability to articulate difficult concepts in an understandable manner.
• Knowledge of Microsoft Word, Excel, Power Point and Outlook.
• Bachelor’s Degree preferably in Health Information Management, Health Administration
• 3+ years of coding experience.
• Hospital coding experience is highly preferred.
This position is located in Lancaster, PA.
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.
Posted: April 15, 2021 at 6:17 PM
Post ID: 60188