Compliance Medical Auditor

Ob Hospitalist Group•,
•$24 - $26•Remote

About The Position

We are seeking a detail-oriented Compliance Medical Auditor and Educator to support coding, billing, documentation, and regulatory compliance for OB hospitalist services. In this remote healthcare compliance role, you will perform professional billing and coding audits, review medical record documentation, deliver provider education, and help strengthen compliant coding practices across the organization. This is an excellent opportunity for a Certified Professional Coder or experienced healthcare compliance professional who enjoys auditing medical records, interpreting coding guidelines, educating physicians and staff, and translating complex compliance requirements into clear, actionable guidance.

Requirements

  • Certified Professional Coder (CPC) from AAPC or Bachelor’s degree.
  • Working knowledge of Medicaid coding regulations is a plus.
  • Awareness of and compliance with HIPAA (Health Insurance Portability and Accountability Act) and related healthcare privacy regulations.
  • Skill in operating a personal computer; must be proficient in Word, Excel, Power Point.
  • Ability to compose letters, memos, and other correspondence.
  • Effective interpersonal skills required in interactions with Ob Hospitalists and personnel.
  • Ability to work independently with minimal supervision required.
  • Ability to work with highly confidential materials.
  • Must possess high ethical standards.

Nice To Haves

  • Experience educating physicians, hospitalists, providers, or staff on coding, charting, documentation, billing, and compliance processes.
  • Strong knowledge of medical terminology, anatomy, coding guidelines, evaluation and management coding, professional billing, and healthcare privacy requirements.
  • Ability to conduct audits, analyze findings, prepare clear audit reports, and communicate recommendations professionally.
  • High attention to detail, sound judgment, strong organizational skills, and commitment to ethical standards.

Responsibilities

  • Conduct billing and coding compliance audits, which may include review of in-patient and out-patient medical records to determine appropriateness of documentation, procedure and diagnosis coding, and evaluation and management coding. Audits will involve professional billing.
  • Conduct analysis and be able to apply state and federal healthcare or related regulations to different questions, projects or inquiries presented to the Compliance Department.
  • Under the direction of the Director of Compliance and the Compliance Manager, works with Commure and Revenue Cycle Management to provide the coding education needed for the Ob hospitalists.
  • Conduct compliance education sessions with the practitioners and other staff who may be involved in coding and billing.
  • Handle inquiries from the Department’s customers on billing and coding compliance-related questions.
  • Assist in the development and roll out of policies and procedures related to auditing, billing and coding.
  • Use a standardized audit tool or tools, including those within Healthicity, for all audits that are in place.
  • Plan and perform work in accordance with internal standards developed by the Compliance Department.
  • Create and utilize a standard audit finding report for communicating the results of the audits in a clear, concise manner.
  • Handle telephone calls in a professional manner; screen all telephone calls and inquiries. Maintain awareness of compliance projects within the department.
  • Assist the Senior Compliance Medical Auditors and Educators with their coding compliance audits, as necessary.
  • Perform Healthmap- and EMR access-related duties to assist and back up the HIM Specialist.
  • Perform other related duties as assigned.

Benefits

  • Paid time off & holidays
  • Medical, dental, and vision insurance
  • Health Savings Account (with employer contribution) or Flexible Spending Account options
  • Employer Paid Basic Life and AD&D Insurance
  • Employer Paid Short- and Long-Term Disability w Optional Short Term Disability Buy-up plan
  • Paid Parental Leave
  • 401(k) Savings Plan with match
  • Legal Plan & Identity Theft Services
  • Mental health support and resources
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