Remote Compliance Specialist

Job Summary

To support compliance initiatives within 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 mitigate 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 of coding and billing risk
• Collaborate with clinical staff to enhance documentation, coding, and compliance practices

Required qualifications

• Bachelor's degree in a relevant field
• 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 such as RHIA, RHIT, CCS, CPC, or CPMA is required
• Preferred experience in formal teaching of coding and specialty coding in surgical or E/M coding