Compliance Analyst (Banking) monitors customer accounts and researches transactions to identify suspicious activity violating current anti-money laundering (AML) regulations defined in the US Bank Secrecy Act (BSA) or other governmental anti-terrorist financing programs. Uses customer data mining and software tools to identify suspicious activity patterns. Being a Compliance Analyst (Banking) reviews daily Currency Transaction Reports (CTR) and Questionable Activity Reports (QAR), and submits Suspicious Activity Reports (SAR) as appropriate. Ensures adherence to Know your Customer (KYC) protocols. Additionally, Compliance Analyst (Banking) may lead or participate in investigations of suspicious activity to pursue corrective actions and ensure completion of required filings. Keeps abreast with regulatory changes, risk management best practices, and trending methods used by fraud perpetrators. Delivers compliance training with up-to-date regulatory information and procedures to develop and guide a well-informed staff. Typically requires a bachelor's degree. May have the Certified Anti Money Laundering Specialist (CAMS) certification. Typically reports to a manager. The Compliance Analyst (Banking) work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Compliance Analyst (Banking) typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Description
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.
Summary:
The Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine and focused audits. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure correction and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on interpretation and application of documentation and coding rules and regulations.
Responsibilities:
• Plans, schedules, and performs comprehensive internal professional and hospital fee audits as determined by the Compliance & Privacy Office Work Plan to include routine and focused audits. Detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure correction and/or appropriate response to identified issues.
• Communicates audit results to providers, coders, management, and other appropriate staff and makes recommendations to ensure sustained improvement.
• Develops and delivers provider and coder education.
• Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional and hospital fee documentation, coding, and billing, including federal and state regulations, CMS, and OIG compliance standards.
• Stays abreast of ever-changing documentation, coding, and billing regulations and standards. Serves as subject matter expert on interpretation and application of documentation and coding rules and regulations.
PARDEE
Other information:
Qualifications
Hired applicants will be expected to hold or obtain an accredited auditing certification.
Required
• Must have 5 years' experience as a coder in a hospital or clinic environment
• Extensive knowledge of evaluation and management coding, modifiers, provider-based billing, and auditing principles
• Strong verbal and written communication skills
• AAPC coding certification (such as CPC)
Preferred
• Three (3) years auditing experience in a hospital or clinic environment
• Auditing certification, CPMA or other accredited auditing certification
01.9593.1545
Legal Employer: Pardee - HCHC
Entity: Pardee UNC Health Care
Organization Unit: Compliance
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: PARDEEHOSP
Exempt From Overtime: Exempt: Yes
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