Quality & Compliance Specialist at Axil Health

Raleigh, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Jul, 26

Salary

0.0

Posted On

11 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare compliance, Clinical auditing, Risk management, Process validation, Medicare program requirements, Data analysis, Attention to detail, Problem-solving, Documentation review, Operational workflows, AI tool proficiency, Communication skills, Regulatory compliance, Quality assurance

Industry

Hospitals and Health Care

Description

Description Quality & Compliance Specialist Join Axil Health as a Quality & Compliance Specialist and play a vital role in ensuring the integrity and accuracy of our clinical documentation and operational workflows. This position offers an exciting opportunity for detail-oriented professionals to contribute directly to our audit and compliance efforts, supporting our commitment to delivering high-quality healthcare services. If you thrive in a fast-paced, high-accountability environment and are passionate about risk management and process validation, we encourage you to apply. Key Responsibilities Audit Validation & Risk Identification - Review and validate 100% of AI-flagged high-risk encounters prior to billing - Confirm true compliance risks and discrepancies in clinical documentation - Track and document identified issues, ensuring clear resolution pathways - Support audit processes by providing accurate and timely validation of encounters - Collaborate with operational teams to address and resolve compliance concerns Audit Reporting: - Produce structured audit outputs for each audit cycle. - Document findings clearly Workflow & Process Compliance Review: - Review operational workflows - Identify where workflows may not align with Medicare program requirements - Flag process-level risks contributing to audit findings - Surface Issues without owning full workflow design Issue Escalation & Collaboration: - Escalate identified issues to appropriate stakeholders - Collaborate with supervisors and operational teams Issue Tracking & Resolution Oversight: - Track all identified audit issues through to resolution - Follow up on unresolved or recurring issues - Identify patters in repeated errors or delays Continuous Improvement Support: - Provide practical recommendations to reduce compliance risk - Support refinement of audit processes and AI tool performance Compliance Alignment: - Evaluate documentation and workflows against Medicare program expectations - Apply learned standards consistently - Ensure audit findings align with current regulatory expectations and internal policies Requirements Education & Experience - Bachelor’s degree preferred in Healthcare Administration, Business, Compliance, or related field - 1–5 years of experience in: healthcare operations quality assurance compliance auditing or other structured, process-driven environments - Healthcare program experience (CCM, RPM, PCM, APCM) is preferred but not required Skills and Qualifications - Proven experience in healthcare compliance, clinical auditing, or related fields - Strong understanding of Medicare program requirements, including CCM, RPM, PCM, and APCM (Preferred) - Excellent attention to detail and analytical skills - Ability to interpret and validate clinical documentation accurately - Effective communication skills for documenting findings and collaborating with teams - Proficiency with AI tools and healthcare data management systems is a plus - High level of integrity, accountability, and problem-solving ability At Axil Health, we foster a collaborative and innovative culture that values continuous improvement and professional growth. We offer competitive benefits and opportunities to develop your expertise in healthcare compliance and quality assurance. Join us in making a meaningful impact on healthcare delivery through meticulous validation and risk management.

Responsibilities

The Quality & Compliance Specialist will validate high-risk clinical encounters and identify compliance risks within operational workflows. They are responsible for tracking audit issues to resolution and providing recommendations for continuous process improvement.