Compliance Specialist

4 weeks ago


Durham, North Carolina, United States Duke University Full time

At Duke University, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, we're dedicated to advancing health together.

About Duke University's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke University's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Key Responsibilities
  • Develop and implement Compliance programs in accordance with the Office of Inspector General's work plan, to reduce institutional and individual provider legal and financial risk through education and internal audits.
  • Provide education and training to providers, clinical, and non-clinical staff regarding compliance with government regulations, with special attention to CMS guidelines as they pertain to academic medical centers, HIPAA, and Fraud and Abuse.
  • Assist in performing analysis through focused reviews of current processes to identify and recommend goals for future clinic needs, identifying coding and billing risk areas, legal medical record compliance risks, and implementing corrective action as needed.
  • Review internal controls, policies, and procedures to ensure compliance with appropriate University, State, and Federal guidelines and policies, sound business and finance practices, and overall organization and clinical goals and objectives.
Requirements
  • Work requires organization, analytical and communication skills generally acquired through the completion of a Bachelor's degree program.
  • Four years of administrative experience to acquire competence in applying compliance, coding and auditing principles as they relate to insurance billing, collections, consulting, and other revenue cycle related functions.
  • RHIA or RHIT or CCS required. For professional coding, specialty coding experience in surgical or E/M coding preferred. CPC or CCS or RHIT or RHIA or CPMA is required.
About Duke University

Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes.

All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities.



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