Compliance Specialist jobs in Raleigh, NC

At Duke Health, 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, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health'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.

Quality Control position reporting to Manager of PB Coding Operations—Medicine and Radiology—that supports coding education and quality

• Coding Onboarding (20%): Provide coding onboarding support to the Manager of PB Coding Operations, Medicine, and Radiology Review of documentation guidelines for the coding of defined specialties for new employees or vendors or existing employees/vendors who are changing specialties Provide quality control reviews of onboarding cases and feedback to employees and vendors on a regular basis. Assist in onboarding new clinical sites, including education on PRMOprocesses processes and coding guidelines

• Coding Quality Control ( 40%): Processes coding-related edits that support defined specialty areas Review the coding of internal staff and external vendors on a monthly basis as a form of quality control Identification of coding and documentation trends for use in the education of coding staff and providers Provide a monthly QC report to the coding manager, including the quality and accuracy of coding f members and team in aggregate for defined

• Coding Education and Newsletters (40%): reviews charging and area and identifies trends that the manager or supervisor will utilize in providing education. o Provide education to coding staff, vendors, and providers on a monthly basis basis, including the coordination of Coding newsletters with each specialty Maintain a thorough understanding of medical record practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), HealthCare/Finance Administration (HC FA), Medical Review of North Carolina (MRNC), etc.

Minimum Qualifications

Education

Work requires an organizational, analytical, and communication skills program. generally acquired through the completion of a Bachelor's degree

Experience

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. For technical coding, two of the four years of experience with DRG's and APR-DRG's are required. Experience in the formal teaching of coding is preferred. RHIA, RHIT or CCS are required. For professional coding, specialty coding experience in surgical or E/M coding is preferred. CPC, CCS, RHIT, RHIA or CPMA are required.

Duke 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. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. 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 essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.