COMPLIANCE SPECIALIST-Inpatient

Durham

Thursday, 18 June 2026

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.

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