Compliance Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform audits related to coding, billing, and documentation to pinpoint compliance, coding, and reimbursement risks.

• Examine medical records and claims to ensure adherence to regulatory, payer, and organizational standards.

• Evaluate audit results, recognize trends and areas for improvement, and suggest corrective measures.

• Create audit reports and relay findings to leadership, healthcare providers, coders, and operational stakeholders.

• Provide education to physicians, coders, and staff on coding, documentation, compliance requirements, and industry best practices.

• Investigate coding and documentation inquiries to facilitate accurate code assignment and reimbursement.

• Assign and verify the use of ICD-10-CM, CPT, HCPCS, and modifiers for both professional and facility services.

• Manage responses to external audits and requests for medical records.

• Stay updated on coding guidelines, payer policies, and healthcare regulations.

• Collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams on monitoring initiatives and compliance efforts.

• Perform additional duties as required.

⛳️ Requirements

• Coding certification from a recognized organization (AAPC, AHIMA, etc.).

• 4-8 years of relevant experience is preferred.

• An undergraduate degree is preferred.

• In-depth knowledge of healthcare coding, auditing, and compliance principles.

• Proven expertise in Medical Oncology, Radiation Oncology, and Urology services.

• Familiarity with CPT, HCPCS, ICD-10-CM, reimbursement methodologies, and healthcare compliance regulations.

• Excellent collaboration and communication skills.

• A detail-oriented and analytical mindset.

• A commitment to accuracy and ongoing professional development.

🏝️ Benefits

• Medical, dental, and vision insurance coverage.

• Paid time off plan.

• Health savings account (HSA).

• 401k retirement savings plan.

• Early access to wages through myFlexPay.

• Flexible spending accounts (FSAs).

• Short- and long-term disability insurance coverage.

• Work-life resources.

• Paid parental leave.

• Healthy lifestyle programs.