Compliance Analyst

Wellpath•Franklin, TN

15h

About The Position

The Compliance Analyst supports Wellpath’s coding compliance and audit program through data collection, analysis, routine coding audits, and report preparation. The role conducts entry- to intermediate-level coding reviews, including services provided in correctional settings and through third-party billing vendors. It maintains audit documentation, prepares regular compliance reports, and supports efficient audit workflows using available tools. The analyst also assists senior auditors and leadership with complex audits, regulatory inquiries, and education initiatives. This position is available only to people residing in the United States.

Requirements

Completion of a formal coding training program through AAPC, AHIMA, or an equivalent organization is required.
A Certified Professional Coder (CPC) credential through AAPC is required.
At least three years of professional medical coding, billing, or coding-audit support experience.
Working knowledge of CPT, HCPCS Level II, ICD-10-CM, and modifier guidelines.
Experience with EMR systems, encoders, and claims or billing workflows.
Familiarity with CMS, OIG, AMA, and payer documentation and coding requirements.
Exposure to state Medicaid coding rules, Section 1115 Reentry Demonstration billing requirements, and correctional health workflows.
Equivalent professional coding credentials and experience may substitute for formal education.

Nice To Haves

Associate's degree in Health Information Management, Health Sciences, Business, or a related field.
Bachelor's degree.
Certified Professional Medical Auditor (CPMA) credential through AAPC, or willingness to obtain it within the first twelve months of employment.
Certified Professional Biller (CPB) credential through AAPC.
Certified Coding Specialist (CCS) through AHIMA may be substituted for an AAPC equivalent.
Experience supporting audits or oversight of third-party billing vendors.
Previous correctional or detention facility experience.

Responsibilities

Conduct routine coding reviews and audits to ensure accurate CPT, HCPCS, ICD-10-CM, and modifier use.
Collect, organize, and validate audit data while maintaining audit workpapers and tracking logs.
Prepare monthly, quarterly, and ad hoc compliance reports and analyze data to identify trends and risks.
Support vendor audits and compliance efforts by reviewing documentation, comparing claims, and tracking remediation activities.
Assist with complex audits, regulatory inquiries, and education materials.
Maintain audit tools and documentation.

Benefits

Medical, dental, and vision benefits.
Paid time off.
401(k).
DailyPay, allowing employees to receive earned wages as they earn them.
Tuition assistance and dependent scholarships.
Employee Assistance Program (EAP), including free counseling and health coaching.
Company-paid life insurance.
Tax-free Health Spending Accounts (HSA).
Wellness program featuring fitness memberships and product discounts.
Preferred banking partnership and discounted rates for home and auto loans.
Ongoing training and development opportunities.