Healthcare Compliance Auditor – Healthcare Transaction & Strategy
Posted 2026-05-06
Remote, USA
Full-time
Immediate Start
- Job Description:
- Plan and perform medical record audits to determine coding accuracy and compliant claims submission
- Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance
- Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards
- Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement
- Serve as a subject matter expert on interpretation and application of coding and documentation guidelines
- Generate client deliverables and make valuable contributions to expert reports
- Manage client relationships and communicate results and work product as appropriate
- Requirements:
- An undergraduate degree (e.g., BS, BA)
- Active coding certification from either AAPC or AHIMA is required
- Preference will be given to candidates that are certified in medical auditing
- 2+ years of work experience with a focus on healthcare provider billing and coding
- 5-7 years of experience is required for the Managing Consultant level position
- Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation
- Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems
- Required skills include: demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools
- Benefits:
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options