Manager Compliance Audit
About The Position
Spectrum Vision Partners (SVP) partners with OCLI Vision (OCLI) to deliver world-class eye care. SVP supports OCLI, one of the largest multi-specialty ophthalmology networks in the U.S. Our collaborative culture is built one hire at a time—and we’re focused on building a team people want to join and patients can’t live without.We want to learn about your experience, your strengths, and the positive, flexible mindset you’ll bring to our team. The Manager, Compliance Audit is responsible for enterprise-wide oversight of billing and coding compliance for clinical services, as well as ensuring timely audits of our transportation, EMR access, and termination procedures. This role ensures adherence to federal and state regulations through auditing, real-time monitoring, education, documentation, corrective action planning, and reporting aligned with the organization’s Compliance Program. This is a role for someone with a strong auditing background as auditing makes up about 80% of this role.
Requirements
- Bachelor’s degree or 10+ years of related experience
- 5+ years medical coding experience & 3+ years auditing experience
- 2+ years in a compliance department
- 2+ years managing staff
- Strong Microsoft Office and project management skills
- Knowledge of Fraud, Waste & Abuse laws
- Skilled in auditing, education feedback, and regulatory documentation
- Analytical, detail-oriented, trustworthy team player
- CPC certification required
Nice To Haves
- Healthcare compliance/privacy certifications preferred
Responsibilities
- Lead prospective and retrospective billing and documentation compliance audits across clinical operations
- Design audit methodologies, tools, sampling techniques, and risk-based monitoring programs
- Analyze physician coding patterns, documentation practices, denials, and reimbursement trends
- Identify compliance risks related to CPT, ICD-10-CM, HCPCS, and modifier usage
- Prepare formal audit reports, compliance investigation summaries, and executive-level metrics
- Develop, implement, and monitor corrective action plans; evaluate effectiveness and sustainability
- Perform ongoing compliance monitoring related to OMIG, CMS, OIG, payer requirements, and sanction/exclusion screening
- Support annual compliance risk assessments and compliance work plans related to coding, billing, and documentation
- Develop and maintain compliance policies, workflows, and education materials
- Deliver provider and staff education on regulatory guidance, documentation standards, and audit findings
- Serve as a subject matter expert and front-line compliance resource for clinics and revenue cycle teams
- Maintain current knowledge of regulatory updates, advisory opinions, and enforcement trends
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
251-500 employees
