Compliance Specialist

Job Summary

To support the Patient Revenue Management Organization, the full-time remote Compliance Specialist will implement and maintain compliance programs, educate providers on regulations, and conduct internal audits to minimize legal and financial risks.

Key responsibilities:

• Educate providers on compliance with government regulations, particularly Medicare and Medicaid guidelines
• Conduct routine internal audits of provider documentation and identify areas for improvement in coding and billing practices
• Collaborate with clinical faculty and administration to promote compliance initiatives and address internal and external concerns

Required qualifications:

• Bachelor's degree in a relevant field
• Four years of administrative experience in compliance, coding, and auditing related to insurance billing and revenue cycle functions
• Two years of experience with DRG's and APR-DRG's for technical coding roles
• Certifications such as RHIA, RHIT, CCS, CPC, or CPMA are required
• Preferred experience in surgical or E/M coding and formal teaching of coding principles