COMPLIANCE AUDITOR - PDC COMPLIANCE
Duke University - Durham, NC

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  • Coding certification (e.g. CPC, CCS, RHIA, RHIT) and technical coding experience is needed.
Work Performed
  • Responsible for conducting non-routine audits, documenting & communicating findings and recommendations, explaining regulatory requirements, and overseeing the corrective actions for audits within DUHS
  • Conduct risk assessments and preparation of work plans.
  • Develop an understanding of the operations, system processes and procedures used in areas being audited.
  • Review and test for compliance with institutional policies and procedures, applicable laws and regulations through the inspection of physical operations, processes, retrieval and review of documents and investigation of irregularities and errors.
  • Compile information and/or prepare reports and analyses setting forth results of compliance audits with appropriate recommendations; perform subsequent audits to ensure complete and appropriate corrective action.
  • Develop recommended corrective actions to address issues detected.
  • Actively participates in exit conferences, providing clarification and supporting information necessary.
Knowledge, Skills and Abilities
Knowledge of billing compliance, knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements. Coding certification (e.g. CPC, CCS, RHIA, RHIT) or applicable experience is preferred.
In depth knowledge of federal regulations
Strong oral and written communication skills. Minimum Qualifications
Education
Bachelor's degree in business administration, accounting, management, healthcare administration, nursing or other related degree
Experience
4 years of experience related to legal, regulatory compliance, or a supervisory role in patient financial services or HIM services

  • Coding certification (e.g. CPC, CCS, RHIA, and RHIT) and technical experience is needed. Position requires a broad knowledge of Medicare billing, coding and documentation requirement and ability to research efficiently such topics.

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