Job description
General Description of the Job Class
Implement and maintain compliance programs by the Office of Inspector General's work plan to reduce institutional and individual provider legal and financial risk through education and internal audits.
Duties and Responsibilities of this Level
Educate providers and clinical and non-clinical staff regarding compliance with government regulations with particular attention to HIPAA Regulations for Patient Rights and CMS guidelines about academic medical centers, HIPAA, and Fraud and Abuse with periodic updates. Provide onboarding training to non-clinical staff related to policies and procedures in HIM-related functions by Federal and State regulations and guidance.
Assist in performing analysis of current situations and recommend priorities and goals for future clinical needs. Identify coding and billing risk areas, and legal and medical record compliance risks, conduct focused reviews, and implement corrective action as needed. 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 organization and clinical goals and objectives. Respond promptly to external and internal concerns, implementing corrective actions as appropriate. Promote compliance initiatives with clinical faculty, staff, and administration.
Perform other related duties incidental to the work described herein.
Education:
Work requires organization, analytical, and communication skills generally acquired through completing a Bachelor's degree program.
Experience:
Four years of administrative experience to acquire competence in applying compliance, coding, and auditing principles as they relat e to insurance billing, collections, consulting, and other revenue cycle-related functions.
Two of the four years of experience with DRGs and APR-DRGs is required for technical coding. Experience informal 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 CPMor CPMA required.
Minimum Qualifications
Education
Work requires organization, analytical and communication skills programs. Generally acquired through the completion of a Bachelor's degree
Experience
Four years of administrative experience to acquire competence in applying compliance, coding and, audting principles related to insurance billing, collections, consulting, and other revenue cycle-relations. For technical coding, two of the four years of experience with DRG's, APR-DRG's is required. Experience in formal teaching of coding is preferred. RHIA or RHIT, 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 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.
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