Job Description - Compliance Auditor-Educator

This position plays a dual role in supporting the organization’s compliance program and ensuring accurate clinical documentation and coding practices. This position is responsible for conducting audits, providing educational feedback to the providers from audited batches to ensure compliance with coding and billing requirements established by the payors, and supporting the development and implementation of compliance initiatives that align with federal and state regulations, payer requirements, and internal policies This position keeps Supervisor and Manager informed of daily progress and issues related to hospital and professional coding and compliance issues. Responsible for obtaining information for billing staff to follow-up on outstanding claims or recording of charges.


 


Minimum Education, Experience, Training, and Licensures Required:



  • High School Diploma or GED required

  • Bachelor’s degree preferred

  • Certified Professional Coder – CPC Certification [or] Certified Coding Associate Coder – CCA Certification required


 


 

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