Compliance Auditor – Medical Coding & Documentation

Precision Healthcare Specialists LLC; Cape Coral, Northern (FL, KY); Hybrid; USD 65,000 - 95,000; Full time

Job summary

Precision Healthcare Specialists LLC seeks a Compliance Auditor to analyze coding accuracy, medical necessity documentation, and regulatory compliance in patient records. Reporting to the VP of Compliance, you will monitor audits and generate metrics to support risk reduction.

You will participate in committees, report findings, and collaborate with multidisciplinary teams to drive process improvement and ensure payer compliance.

Qualifications

• RN or LPN required.
• 3–5 years experience in Medicare/Medicare Advantage and/or Commercial Payers.
• Strong knowledge of Florida statutes, Medicare & Medicaid conditions of participation and payer guidelines.

Responsibilities

• Conduct compliance focused monitoring and audits related to coding accuracy, medical necessity, documentation and operations.
• Perform ad hoc reviews and audits based on high risk areas.
• Maintain tools, reports, data, metrics, benchmarking and trending of patient and compliance data.
• Participate in committees to address risks and drive improvement initiatives.
• Provide reports to management on compliance metrics and audit findings.

Skills

Regulatory interpretation

Prioritization

Independent work

Collaboration

Education

RN or LPN required

Job description

Precision Healthcare Specialists LLC seeks a Compliance Auditor to analyze coding accuracy, medical necessity documentation, and regulatory compliance in patient records. Reporting to the VP of Compliance, you will monitor audits and generate metrics to support risk reduction.

You will participate in committees, report findings, and collaborate with multidisciplinary teams to drive process improvement and ensure payer compliance.