Compliance Auditor

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Requirements:

• 2+ years of relevant compliance auditing experience.
• Bachelor’s degree in Health Information Management or related field.
• Professional Designation: CHC or willingness to obtain certification.
• Experience in evaluating compliance with laws and regulations.
• Proficiency in medical coding, billing practices, and CMS requirements.
• Strong analytical skills for identifying trends, addressing discrepancies, and proposing solutions.
• Deep understanding of HIPAA regulations, confidentiality, and compliance requirements.
• Ability to work both independently and collaboratively with cross-functional teams.

Responsibilities:

• Conduct detailed audits of compliance concerns including medical records to ensure accuracy in coding and billing practices.
• Review documentation to identify and correct coding and billing errors, ensuring compliance with medical necessity and regulatory guidelines.
• Log and track audit results and documentation workflows.
• Analyze trends and discrepancies in coding and billing practices, providing actionable insights and recommendations for improvement.
• Collaborate with internal teams to improve documentation standards and ensure compliance with relevant regulations.
• Participate in process improvement initiatives, team meetings, and department projects to enhance audit workflows and overall efficiency.