Compliance Specialist

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🔥 12 minutes ago

🏈 Alabama, Arizona, +21 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – 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

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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 • Reduce institutional and individual provider legal and financial risk through education and internal audits • Educate providers on government regulations, including Centers for Medicare and Medicaid guidelines, HIPAA, and fraud and abuse • 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 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 • Respond to external and internal 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 functions • For technical coding, two of the four years of experience with DRGs and APR-DRGs required • RHIA, RHIT, or CCS certification required for technical coding • For professional coding, specialty coding experience in surgical or E/M coding preferred • CPC, CCS, RHIT, RHIA, or CPMA certification required for professional coding • Experience in formal or informal teaching of coding preferred • Knowledge of government regulations, Centers for Medicare and Medicaid guidelines, HIPAA, and fraud and abuse • Organization, analytical, and communication skills • Ability to perform coding, documentation, compliance, and internal auditing reviews • Must reside in one of the listed states: 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 • Equal employment opportunity and nondiscrimination commitment • Reasonable accommodation information and provisions