Compliance Data Analyst

Corporate Compliance

Full Time

Day Shift

Between 7am - 6pm

Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcare and was first in the state to achieve Magnet with Distinction status for excellence in nursing care. Consistently ranked as best in the Columbia Metro area by U.S. News & World Report, Lexington Health delivers more than 4,000 babies each year, performs more than 34,000 surgeries annually and is the regions third largest employer.

Lexington Health also includes an accredited Cancer Center of Excellence, the state's first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer's care center. Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.

Job Summary

Under the general direction of the Compliance Audit Manager, facilitates the generation of risk based data mining within Epic. Analyzes data and determines areas of risk, stays abreast of all regulatory, and state updates in order to assist in determining areas of risk and noncompliance for the organization. Is responsible for generating all reports and data used for Corporate Compliance audit and monitoring.

Minimum Qualifications

Minimum Education: High School Diploma or Equivalent

Minimum Years of Experience: 4 Years of directly related health care experience

Substitutable Education & Experience (Optional): 4 Years of experience can be substituted for an Associates Degree with 2 Years of directly related experience or a Bachelors Degree in business or related field.

Required Certifications/Licensure: Certified Professional Coder

Required Training: Strong Problem solving skills;

Ability to articulate orally and in writing an understanding of complex issues and detailed action plans, while representing the organization professionally (communicates with physicians, Advanced Practice Providers (APPs), senior administrators and department staff);

Advanced level of proficiency and knowledge of Microsoft Excel, Pivot tables, ICD-10 and CPT;

Strong background in regulatory rules and guidelines and risk based trends in healthcare.

Essential Functions

• Responsible for facilitating data mining reports generated from Epic for the Auditors as needed.
• Works closely with EPIC analysts when areas of risk are identified.
• Works closely with other departments, Health Information Management and Revenue Integrity to conduct coding reviews and inquires.
• Uses Comply Track Assessment tool to help identify areas of risk within Lexington Medical Center (LMC).
• Participates in risk assessment of areas of focus designated by the Recovery Audit Contractors, MIC, OIG, ZPIC and other regulatory agencies.

Duties & Responsibilities

• Consults with the Revenue Integrity personnel and the Compliance Audit Manager when relevant issues of federal and state health care billing law and regulations are discovered to create overpayments.
• Keeps abreast of ICD-10, CPT-4, and HCPCS coding changes, compliance issues and regulations and provides communication and updates regarding changes in regulations, policies or procedures pertaining to the Compliance Program.
• Treats patients, fellow employees and all individuals met while representing Lexington Medical Center with courtesy and respect in keeping with the LMC vision.
• Adheres to organization wide policies.
• Performs all other duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance - equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer

It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.