North Carolina Licensed Compliance Specialist

Job Summary

To support the Patient Revenue Management Organization, the remote North Carolina Licensed Compliance Specialist will implement and maintain compliance programs, educate providers on regulations, and conduct internal audits to reduce legal and financial risks associated with billing and coding.

Key responsibilities

• Educate providers on compliance with government regulations, particularly Medicare and Medicaid guidelines
• Conduct routine internal audits of provider documentation and implement corrective actions as needed
• Collaborate with internal staff to enhance documentation, coding, and compliance capabilities

Required qualifications

• Bachelor's degree required
• Four years of administrative experience in compliance, coding, and auditing related to insurance billing
• Two years of experience with DRGs and APR-DRGs for technical coding roles
• Certification as RHIA, RHIT, or CCS required
• Preferred experience in surgical or E/M coding for professional coding roles