Professional Billing Compliance Auditor

Intermountain Health • Dayton, OH

1d • $34 - $53 • Remote

About The Position

Professional Billing Compliance Auditor (Physician Billing) Bring your compliance expertise to a role that helps protect patients, caregivers, and the integrity of a complex healthcare system. As a Senior Compliance Consultant, you will partner with leaders across the organization to identify, assess, and address medium-complexity compliance risks, with a strong focus on physician billing and reimbursement. You’ll translate risk assessment findings into clear, actionable recommendations, support corrective action planning, and deliver education that strengthens a culture of compliance and ethical decision-making.

Requirements

• Extensive knowledge of physician billing within a hospital system.
• Working knowledge of healthcare regulations and the ability to apply compliance program principles in day-to-day work.
• Strong communication skills (written, verbal, and interpersonal) and the discretion to handle confidential matters with sound judgment.
• Proven ability to prioritize multiple assignments, collaborate across teams, and solve problems in a fast-changing environment.
• Certified Professional Coder (CPC) national professional coding certification, highly preferred
• Three or more years of experience in physician coding and reimbursement, highly preferred
• High School Diploma or GED preferred.
• Bachelor’s Degree in healthcare administration or relative field preferred.
• Demonstrated professional experience in healthcare, compliance or related field.
• Demonstrate knowledge of health care regulations.
• Demonstrate effective verbal, written, and interpersonal communications.
• Demonstrated discretion to maintain confidential information, evaluate alternatives, and make effective decisions.
• Ability to work in a rapidly changing environment within formal and informal teams.
• Demonstrate Intermediate problem-solving skills with effective coordination with diverse stakeholders and multiple areas and levels of the organization.
• Ability to prioritize various assignments.
• Demonstrate a strong understanding of and ability to apply the 8 elements of an effective compliance program.
• Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with customers that require employee to communicate as well as understand spoken information, alarms, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment.
• Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment.
• Typically includes items of varying weights, up to and including heavy items.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles

Nice To Haves

• Certified Professional Coder (CPC) national professional coding certification
• 3+ years of experience in coding and reimbursement

Responsibilities

• Develops and promotes effective mechanisms to encourage a culture of compliance and reporting.
• Participates in the implementation of regulatory requirements through projects and assignments.
• Supports the implementation of the 8 elements of a compliance program.
• Evaluates and identifies risks and supports corrective action plans.
• Provides consultation and information to senior management, staff, and partners on compliance issues and best practices.
• Conducts compliance audits, reviews, and assessments to evaluate compliance status and identify areas of improvement or concern.
• Prepares and presents reports, findings, and recommendations to relevant audiences.
• Coordinates and facilitates compliance training and education for staff and stakeholders.
• Investigates and responds to compliance complaints, incidents, and breaches, and implement corrective and preventive actions.
• Establishes and maintains effective relationships and communication channels with appropriate stakeholders.
• Identifies and implements best practices and continuous improvement initiatives to enhance the regulatory compliance performance and culture of the organization.
• Responsible for the promotion and awareness of positive ethical and moral principles consistent with the Mission, Vision, and Values of Intermountain Health.
• Executes vision and multiple strategic priorities.
• Links day-to-day compliance activities to strategic objectives/priorities.

Benefits

• We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
• Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED