Quality & Compliance Specialist

Axil Health • Raleigh, NC

7h

About The Position

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.

Requirements

• 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
• 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

Nice To Haves

• Healthcare program experience (CCM, RPM, PCM, APCM) is preferred but not required
• Strong understanding of Medicare program requirements, including CCM, RPM, PCM, and APCM (Preferred)
• Proficiency with AI tools and healthcare data management systems is a plus

Responsibilities

• 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
• Produce structured audit outputs for each audit cycle.
• Document findings clearly
• 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
• Escalate identified issues to appropriate stakeholders
• Collaborate with supervisors and operational teams
• Track all identified audit issues through to resolution
• Follow up on unresolved or recurring issues
• Identify patters in repeated errors or delays
• Provide practical recommendations to reduce compliance risk
• Support refinement of audit processes and AI tool performance
• Evaluate documentation and workflows against Medicare program expectations
• Apply learned standards consistently
• Ensure audit findings align with current regulatory expectations and internal policies

Benefits

• We offer competitive benefits and opportunities to develop your expertise in healthcare compliance and quality assurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level