Compliance Auditor

Compass Health Network; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Compass Health Network is seeking a Compliance Auditor to strengthen documentation quality and ensure regulatory compliance across our care communities. This remote role is open to Missouri residents and collaborates with clinical, finance, and operational teams to audit documentation, educate providers, and support accurate reimbursement.

The position emphasizes data analysis, trend identification, and continuous improvement of documentation practices to support high-quality patient care and

Qualifications

• Minimum 1 year of medical terminology experience.
• Experience working with diverse healthcare teams.
• Familiarity with government healthcare reimbursement systems.
• ICD-10 and CPT familiarity

Responsibilities

• Audit documentation for completeness and payer compliance.
• Use audit tool software to document findings.
• Collaborate with internal audit on projects and improve processes.
• Educate providers on audit findings clearly.
• Analyze anomalies and escalate appropriately.
• Review and resolve claim rejections and reimbursement discrepancies with Patient Accounting.

Skills

Medical terminology

Collaborative teamwork

Healthcare compliance

Regulatory awareness

Education

High School/GED

Tools

Excel

EHR systems

Job description

Compliance Auditor

Help strengthen documentation quality and support compliant, high-impact care across the communities we serve. Remote position open to Missouri residents only.

The Compliance Auditor plays an important role in supporting clinical documentation accuracy, regulatory compliance, and continuous quality improvement across the organization. This position partners with clinical, finance, and operational teams to audit documentation, identify trends, provide education, and help ensure services are documented in a way that supports quality care, compliance standards, and accurate reimbursement.

This is a great opportunity for someone who enjoys problem-solving, analyzing data and trends, collaborating across departments, and helping improve systems and processes that support patient care and organizational excellence.

Key Responsibilities

• Audits service documentation for completeness, accuracy and compliance with payer requirements
• Utilizes audit tool software to conduct audits, document findings and support audit activities
• Collaborates with internal audit staff on joint projects and identifies and communicates opportunities to improve audit processes
• Educates providers on audit findings and communicates results clearly, concisely and accurately
• Analyzes anomalies identified through audit processes and escalates findings for further review as appropriate
• Applies program-specific regulatory requirements and dual-program audit procedures when conducting audits
• Performs audit activities in accordance with established efficiency standards and expectations set by Audit Services leadership
• Meets regularly with Compliance and Audit leadership to discuss audit findings, processes, priorities and opportunities for improvement
• Evaluates the impact of clinical and operational changes on audit processes and implements or recommends actions to mitigate identified risks
• Participates in the review and resolution of claim rejections and reimbursement discrepancies in collaboration with Patient Accounting to support accurate reimbursement and regulatory compliance
• Monitors documentation trends, identifies potential deficiencies and compliance concerns, and reports findings to appropriate personnel
• Conducts follow-up clinical documentation improvement education based on audit findings and results
• Reviews medical codes using ICD-10 and CPT coding systems to assess coding accuracy and compliance with applicable requirements
• Extracts and analyzes reports from applicable electronic health record (EHR) systems to support auditing, monitoring and reporting activities
• Performs other duties as assigned

Requirements, Skills, Knowledge and Expertise

• 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
• Experience in ICD, DSM V, and Excel preferred

You'll be a great fit for this role if you:

• Are detail-oriented and highly organized, with the ability to manage multiple priorities effectively
• Enjoy working both independently and collaboratively to improve processes and outcomes
• Can interpret data and identify patterns that support compliance and operational improvement
• Communicate clearly and professionally with clinical and administrative teams
• Value accuracy, accountability, and continuous learning in a healthcare environment
• Are passionate about supporting quality care and strengthening services for rural communities through strong documentation and compliance practices