Compliance Specialist

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🏈 Alabama, Arizona, +20 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🗻 New Hampshire – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ☕ Washington – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 13%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Duke Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

💼 Consulting

🏥 Healthcare

📚 Education

Consulting • Healthcare • Education

Duke Careers is a platform connected to Duke University's rich legacy, established in 1924. It aims to celebrate the centennial of Duke University while providing resources, stories, and interviews that reflect the university's history, current achievements, and future aspirations. A key focus of Duke Careers is to engage with alumni and the community, showcasing the transformative impact of education and leadership within the university.

📋 Description

• Implement and maintain compliance programs in accordance with the Office of Inspector General's work plan • Educate providers on government regulations, Medicare and Medicaid guidelines, HIPAA, fraud and abuse, and compliance updates • Analyze current situations and recommend priorities and goals for future clinic needs • Identify coding and billing risk areas, conduct focused reviews, and implement corrective actions • Conduct timely routine internal audits of provider documentation • Collaborate with physicians and internal staff to improve documentation, coding, and compliance capabilities • Review internal controls, policies, and procedures for compliance with university, state, and federal guidelines and sound business and finance practices • Respond promptly to internal and external concerns and implement corrective actions • Communicate with Medicare/Medicaid carriers and third-party payers regarding policies and procedures • Promote compliance initiatives with clinical faculty and administration • Perform other related duties incidental to the work described

🎯 Requirements

• Bachelor's degree • Four years of administrative experience applying compliance, coding, and auditing principles to insurance billing, collections, consulting, and other revenue cycle-related functions • For technical coding, two of the four years of experience with DRGs and APR-DRGs is required • RHIA, RHIT, or CCS required for technical coding • For professional coding, specialty coding experience in surgical or E/M coding is preferred • CPC, CCS, RHIT, RHIA, or CPMA required for professional coding • Organization, analytical, and communication skills • Knowledge of government regulations, Centers for Medicare and Medicaid guidelines, HIPAA, fraud and abuse, coding, billing, auditing, and compliance • Remote workers must reside in North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, or Washington

🏖️ Benefits

• $10,000 sign-on bonus paid in 4 equal installments over 24 months at 6-month increments • 100% remote work arrangement • Reasonable accommodation provisions • Equal opportunity and nondiscrimination commitment