Compliance Auditor

Role Overview

• Audit and monitor clinical documentation and service records for accuracy and compliance
• Utilize audit tools and reporting systems aligned with regulatory and reimbursement requirements
• Identify documentation trends, gaps, and compliance concerns, and communicate findings appropriately
• Support clinical documentation improvement efforts through education and follow-up auditing
• Collaborate with internal teams, including finance and patient accounting, on documentation and claims review processes
• Review coding and documentation using ICD-10 and CPT standards
• Generate and analyze reports to support compliance monitoring and operational improvement
• Maintain working knowledge of the organization’s electronic health record (EHR) systems
• Communicate effectively with providers, staff, and interdisciplinary teams

Requirements

• High School/GED required
• At least one (1) year of medical terminology preferred
• Must have experience working collaboratively with diverse groups in a healthcare environment
• Must be familiar with government healthcare reimbursement systems
• Must have knowledge of anatomy and physiology
• Must be successful in interacting effectively with providers
• Must have the ability to analyze large amounts of data to identify trends
• Experience in ICD, DSM V, and Excel preferred