Government Program Compliance Analyst - Reimbursement

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:
Responsible for research, analysis and review, and completion of required enrollment forms for Centers for Medicare and Medicaid Services on behalf of UNC Health Care System's facilities. Monitors compliance with policies and procedures and makes recommendations for changes as appropriate.

Responsibilities:
1. Assists with the annual UNC Health Care System licensure submission and assists with DHRS visits by maintaining and supplying hospital-based clinic/ancillary and NPI/PTAN data. Assists with the various required Competitive Bidding submissions for the DME provider.
2. Collaborates with Pharmacy Administration and staff across UNC Health Care System to ensure all hospital-based clinics/ancillaries are accounted for under the 340b programs for each 340b hospital.. Collaborates with Legal and UNCHCS Joint Commission staff to ensure all hospital-based clinics/ancillaries are accounted for under the Joint Commission accreditation. Maintains master facility listings for each of the UNCHCS hospitals for all of its NPI?s.
3. Collaborates with Senior Leaders and Strategic Planning across affiliates to advise on requirements for opening and operating a facility that would receive Medicare, Medicaid reimbursement by researching state licensure requirements, CMS regulations and additional Medicare and Medicaid regulations to ensure compliance.
4. Creates entity and hospital non-physician practitioner NPI?s and maintains the NPI data file in the NPPES System.
5. Establishes and maintains positive, ongoing relationships with MAC, NCDMA, DHSR, CMS RO and Call Centers. Coordinates the NC Tracks- Medicaid system issues for UNC HCS. Researches payment issues, lapse of ability to be open and make changes to locations, ability to monitor the completion of applications and attestations submitted. Works closely with above agencies to ensure all information submitted is accepted/applied, thus provider remains in good standing with CMS, NCDMA, MAC etc.
6. Gathers necessary information and completes required forms to enroll non-physician hospital staff into the Medicare Program and re-assign their billing rights to the appropriate entity/entities.
7. Monitors compliance with policies and procedures and makes recommendations to senior leaders, staff, etc of all UNCHCS facilities for changes as appropriate.
8. Responsible for revalidations for UNC Health Care System for Medicare and Medicaid, including submission and re-submission of the Electronic Funds Transfer information. This ensures that the providers remain active in the CMS MAC, Medicaid systems for authorization for treatments through to payment.
9. Responsible for the completion of required attestation forms and supporting documentation for the CMS Regional Office and Medicare Administration Contractor of each off-site location, including clinics and ancillary services, providing hospital based services within UNC Health Care System?s hospitals and other facilities as applicable. Working with and educating the department heads, clinic managers, and senior leaders about the regulatory requirements for both on-campus and off-campus hospital locations. Maintains master hospital-based location listings for each of the UNCHCS hospitals. Works with EPIC Team, clinic managers and CDM Director to ensure the appropriate hospital-based names are in the EPIC System.

Other information:
Education Requirements:
* Bachelor's degree in Accounting, Business Administration, Finance or related field (or equivalent combination of education, training and experience).
Licensure/Certification Requirements:
* No licensure or certification required.
Professional Experience Requirements:
* If a Bachelor's degree: Five (5) years of Medicare Administrative Contractor (MAC) experience, compliance, strategic planning, enrollment/attestation or extensive accounting experience within a hospital.
* If an Associate's degree: Nine (9) years of Medicare Administrative Contractor (MAC) experience, compliance, strategic planning, enrollment/attestation or extensive accounting experience within a hospital.
* If a High School diploma or GED: Thirteen (13) years of Medicare Administrative Contractor (MAC) experience, compliance, strategic planning, enrollment/attestation or extensive accounting experience within a hospital.
Knowledge/Skills/and Abilities Requirements:

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Reimbursement

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$38.55 - $55.43 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

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.