Compliance Auditor

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

📋 Description

• The Compliance Auditor, reporting directly to the VP of Compliance, is tasked with the continuous analysis and assessment of coding accuracy, medical necessity documentation, and adherence to regulatory standards in patient records.

• Perform compliance-oriented monitoring and audits concerning coding precision, medical necessity, supporting documentation, and various operational functions.

• Execute ad hoc reviews and audits targeting high-risk, problematic, or otherwise designated areas.

• Manage tools, reports, data, metrics, benchmarking, and the tracking and trending of patient and compliance data.

• Engage in multiple committees to tackle risks and identify opportunities for improvement, report on compliance data, and collaborate on process enhancement initiatives.

• Prepare reports for management detailing compliance metrics and audit findings upon request.

⛳️ Requirements

• An RN or LPN license is required.

• A Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) designation is highly preferred.

• A minimum of three to five years of experience with Medicare, Medicare Advantage, and/or Commercial Payers is preferred.

• Strong understanding of Florida statutes, Medicare & Medicaid conditions of participation and payment, as well as commercial payer guidelines, is preferred.

🏝️ Benefits

• Comprehensive health and wellness programs.

• Opportunities for professional development and advancement.

• Competitive salary and incentive packages.

• Supportive work environment with a focus on team collaboration.