Vanderbilt University Medical Center · 5 hours ago
Principal Compliance Specialist (Auditor/Clinician Educator) (Coding certification required) - HYBRID
Nashville Metro
Full-time
Hybrid
Senior Level, Lead/Staff
7+ years expVanderbilt University Medical Center, located in Nashville, Tennessee, is a leading institution in teaching, discovery, and patient care. They are seeking a Principal Compliance Specialist to evaluate and advise on compliance standards for hospital documentation and coding, while also providing training and oversight for compliance staff. The role involves conducting audits, analyzing data for compliance risks, and leading educational initiatives for clinical stakeholders.
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Responsibilities
Evaluates internal and external data and documentation to identify patterns, errors, and risk factors, assess potential areas of non-compliance and vulnerability to audit by health oversight agencies and contractors
Recommends and assists in the scoping, planning, and design of subject matter review and clinician-focused (structured) review projects
Serves in a quality assurance role with responsibility for ensuring that auditing and monitoring performed by other individuals, including third-party consultants, is correct, complete and accurate. Escalates issues or concerns
Performs audits and analyses and assists in the drafting, editing and finalization of OCCI reports resulting from completed subject matter and structured reviews
Research and analyze issues in response to requests for assistance from the OCCI team and from other VUMC stakeholders. Leads virtual meetings with VUMC clinical and administrative stakeholders to provide education and guidance on documentation, coding, pertinent policy/SOPs, and billing topics
Independently perform audit reviews of contracts, systems, processes, documentation and billing
Maintains current knowledge of policy, legal and regulatory standards. Attends and participates in subject matter review entrance and exit conferences
The responsibilities listed are a general overview of the position and additional duties may be assigned
Provides hands-on training and day-to-day productivity and quality oversight of Compliance Specialists and Senior Compliance Specialists in the department, as well as any external contracted services used by our office for auditing and consulting services
Leads efforts to understand, develop and deploy Artificial Intelligence (AI) technology in the review/audit process
Works with MDaudit and other vendors to help ensure the tools we utilize are continually evaluated for enhancements that will reduce manual intervention in the audit/review process; improve accuracy of findings and enhance educational materials
Qualification
Required
Coding Certification Required... Must have one of the following certs: CPC, CCS, COC, RHIA, RHIT, etc
7 years of relevant work experience
Bachelor's degree (Required)
Company
Vanderbilt University Medical Center
Vanderbilt University Medical Center is a nonprofit institution specializing in patient care, research, and nobility in medical education.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$35.3MKey Investors
National Institute on AgingAdvanced Research Projects Agency for HealthGordon and Betty Moore Foundation
2025-07-02Grant· $25M
2024-11-15Grant· $3.3M
2024-09-13Grant
Leadership Team
Wright Pinson
Deputy CEO and Chief Health System Officer
Cecelia Moore
Chief Financial Officer & Treasurer
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