COMPLIANCE SPECIALIST

PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke’s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.

The Compliance Specialist is responsible for evaluating, analyzing, and maintaining an accurate and meaningful Coding database for the hospital services, reflective of patient mix and resource use through monitoring of coding compliance by the Office of Inspector General’s Work Plan, education, and internal audits.

Minimum Qualifications

Education

Work requires organization, analytical, and communication skills program generally acquired through the completion of a Bachelor's degree

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 DRGs and APR-DRGs 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 is preferred. CPC or CCS or RHIT or RHIA or CPMA is required.

Duke is an Affirmative Action/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, sexual orientation, or veteran 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 essentialjob 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.