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Full-time
bachelor degree, professional certificate
Sign-on Bonus
Posted 7d ago
~40 hrs/week
Remote in Alabama, United States, Arizona, United States, Connecticut, United States, District of Columbia, United States
Responsibilities
Implement and maintain compliance programs to reduce legal and financial risks through provider education and internal audits. Collaborate with physicians to improve documentation and coding while ensuring adherence to University, State, and Federal guidelines.
Requirements
Requires a Bachelor's degree and four years of administrative experience in compliance, coding, and auditing. Mandatory certifications include RHIA, RHIT, CCS, CPC, or CPMA.
Full job description
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.
This position is 100% remote. All Duke University remote workers must reside in one of the following states:
North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.
*Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments.
Occ Summary
Implement and maintain 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.
Work Performed
Educate providers in regarding compliance with government regulations with special attention to Center for Medicare and Medicaid guidelines as they pertain to academic medical centers, HIPAA, and Fraud and Abuse with periodic updates. Assist in performing analysis of current situations and recommend priorities and goals for future clinic needs. Identify coding and billings risk areas, conduct focused reviews, and implement corrective action as needed.Conduct routine internal audits of provider documentation on a timely basis. Collaborate with physicians and internal staff in development of improved capabilities in the areas of documentation, coding, and compliance. 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 clinical goals and objectives. Respond promptly to external and internal concerns; implementingcorrective actions as appropriate. Communicate with Medicare/Medicaid Carriers and third party payers regarding policies and procedures. Promote Compliance initiatives with clinical faculty and administration. Perform other related duties incidental to the work described herein.
Knowledge, Skills and Abilities
Educate providers in regarding compliance with government regulations with special attention to Center for Medicare and Medicaid guidelines as they pertain to academic medical centers, HIPAA, and Fraud and Abuse with periodic updates. Assist in performing analysis of current situations and recommend priorities and goals for future clinic needs. Identify coding and billings risk areas, conduct focused reviews, and implement corrective action as needed. Conduct routine internal audits of provider documentation on a timely basis. Collaborate with physicians and internal staff in development of improved capabilities in the areas of documentation, coding, and compliance. 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 clinical goals and objectives. Respond promptly to external and internal concerns; implementing corrective actions as appropriate. Communicate with Medicare/Medicaid Carriers and third party payers regarding policies and procedures. Promote Compliance initiatives with clinical faculty and administration. Perform otherrelated duties incidental to the work described herein.
Level Characteristics
Educate providers in regarding compliance with government regulations with special attention to Center for Medicare and Medicaid guidelines as they pertain to academic medical centers, HIPAA, and Fraud and Abuse with periodic updates. Assist in performing analysis of current situations and recommend priorities and goals for future clinic needs. Identify coding and billings risk areas, conduct focusedreviews, and implement corrective action as needed. Conduct routine internal audits of provider documentation on a timely basis. Collaborate with physicians and internal staff in development of improved capabilities in the areas of documentation, coding,and compliance. 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 clinical goals and objectives. Respond promptly to external and internal concerns; implementing corrective actions as appropriate. Communicate with Medicare/Medicaid Carriers and third party payers regarding policies and procedures. Promote Compliance initiatives with clinical faculty and administration. Perform other related duties incidental to the work described herein.
Minimum Qualifications
Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military 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 essential job 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.
Education
Work requires organization, analytical and communication skills generally acquired through the completion of a Bachelor's degree program.
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 is required. Experience in formal teaching of coding is preferred. 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.
Degrees, Licensures, Certifications
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'sand APR-DRG's is required. Experience in formal teaching of coding is preferred. 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.
Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military 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 essential job 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.
Related keywords
ComplianceInpatientRevenue CycleDRGAPR-DRGRHIARHITCCSCPCCPMAHIPAAMedicareMedicaidMedical BillingInternal AuditFraud and Abuse
We put the person who needs our care at the center of everything we do.
Industry
Hospitals and Health Care
Company size
10,001+ employees
Founded
1925
Headquarters
Durham, North Carolina
LinkedIn followers
24,200
Duke University Hospital (DUH) is consistently rated as one of the best hospitals in the United States and is known around the world for its outstanding care and groundbreaking research.
Driven to bring extraordinary discoveries to fruition, deliver cutting edge clinical services to patients, and apply care and compassion to all stages of care, we maintain an unwavering focus on making the individuals and communities we serve healthier.
Today, DUH is the flagship of the Duke University Health System and a full-service, 957-bed, tertiary and quaternary academic medical center. Ranked nationally in 10 adult specialties by U.S. News and World Report for 2019-2020 and ranked first in North Carolina and first in the Raleigh-Durham area, care is delivered with inspiring passion and a deep commitment to put the person who needs our care at the center of everything we do.
Offices: 2301 Erwin Rd, Durham, North Carolina 27705, US
How much do Healthcare jobs in North Carolina pay?
Based on 2252 listings with disclosed salaries, most healthcare jobs in North Carolina pay between $59k–$162k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in North Carolina right now?
There are currently 17,557 open healthcare positions in North Carolina listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in North Carolina?
Companies currently hiring include American Addiction Centers, Duke Health Technology Solutions, CVS Health, Duke University Hospital, PruittHealth, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in North Carolina?
Yes — 1796 of the 17557 open healthcare positions offer remote or hybrid work (660 remote, 1136 hybrid).
How do I apply for Healthcare jobs in North Carolina?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.