Compliance Auditor -Remote

Providence•Renton, WA

2d•Remote

About The Position

Providence is calling for a Compliance Auditor - Remote. The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT. This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing line-item charges, Revenue Codes, CPT descriptions, status, orders, supporting documentation, and reimbursement etc. The auditor applies strong critical thinking and analytical skills to evaluate accuracy, identify discrepancies, and ensure compliance while completing focused audits. Audit findings are presented in a collaborative manner (verbally and visually) looking to a common goal of reducing risk within Providence as a system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure 60 Day Overpayment Rule. This position works remotely and is open to candidates residing in: Alaska, Washington, Montana, Oregon, California, Texas, New Mexico. Providence caregivers are not simply valued – they’re invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Requirements

Bachelor's Degree in Business, Healthcare, Finance, or similar field, OR 5 years of recent Hospital Billing auditing, Nurse Auditing, or Hospital billing and coding experience.
5 years of recent Hospital billing auditing or Hospital coding experience.

Nice To Haves

Coding Certification from American Health Information Management Association

Responsibilities

Conducts audits to evaluate compliance with Federal and State laws, regulatory rules & regulations, PSJH policies and procedures.
Audits may involve clinical and non-clinical services, including revenue cycle departments, billing offices, external vendors, HIM coding, Revenue Integrity, Chargemaster CDM, EPIC, and Clinical Documentation CDT.
Navigates and analyzes data across Clinical EMR and Epic Billing systems, reviewing line-item charges, Revenue Codes, CPT descriptions, status, orders, supporting documentation, and reimbursement.
Applies critical thinking and analytical skills to evaluate accuracy, identify discrepancies, and ensure compliance.
Presents audit findings collaboratively (verbally and visually) to reduce risk within Providence.
Refunds overpayments received in error following the CMS Voluntary Self Disclosure 60 Day Overpayment Rule.