Compliance Auditor Analyst

RadNet•Village of Fairport, NY

About The Position

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Leading Radiology Forward. With dynamic cross-training and advancement opportunities in a team-focused environment, the core of our success is its people with the commitment to a better healthcare experience. When you join us as a Compliance Auditor Analyst, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes.

Requirements

CPC, CCS‑P, RCC, RHIT/A, or equivalent by the American Academy of Professional Coders Certified Professional coder required.
5+ years of experience in healthcare coding, billing, auditing, and/or compliance preferred.
Associate’s or Bachelor’s degree preferred; equivalent experience in healthcare compliance, auditing, or coding accepted.
Advanced knowledge of CPT, ICD‑10, HCPCS, and payer reimbursement methodologies.
Demonstrated ability to interpret regulations, analyze complex data, and exercise independent judgment.
Proficiency in Microsoft Excel, Word, and audit management tools.
Strong written and verbal communication skills, including the ability to prepare analytical reports and present findings to leadership.
Ability to evaluate information, draw conclusions, and make recommendations based on regulatory standards and audit evidence.
Knowledge of compliance program requirements, healthcare regulatory frameworks, and audit theory.

Nice To Haves

Experience working with AI tools is a plus.

Responsibilities

Independently conducts and documents compliance audits of medical records, coding, and billing in accordance with regulatory requirements, internal policies, and audit standards.
Analyzes audit results to identify trends, root causes, and systemic risks; develops recommendations for corrective action and process improvement.
Interprets federal and state healthcare regulations, payer policies, and internal compliance standards to ensure audit methodology and findings align with regulatory expectations.
Develops audit tools and evaluation criteria for new or evolving compliance initiatives.
Prepares comprehensive audit reports for leadership, including analyses, findings, risk implications, and recommended actions.
Advises operational leaders, coders, and clinical teams on compliance risks, documentation requirements, and regulatory interpretations.
Maintains and enhances the compliance audit database, ensuring accuracy, integrity, and accessibility of audit documentation.
Collaborates with Compliance leadership to design and implement monitoring programs, training initiatives, and policy updates.
Participates in compliance investigations, risk assessments, and special projects requiring analytical expertise.
Performs other duties and projects as assigned.