Compliance Integrity Auditor Analyst

Asante; Medford (OR); Remote; USD 79,000 - 108,000; Full time

Benefits offered by this job

Competitive Pay

Health & Wellness

Retirement Savings

Paid Time Off

Professional Development

Life Insurance

Disability Coverage

Employee Assistance Programs

Job summary

Asante seeks a Compliance & Integrity Auditor and Analyst for a remote, U.S.-based role. The incumbent will audit medical records and billing documentation, ensuring compliance with CPT/ICD-10-CM/HCPCS, HIPAA, and related laws.

They will develop corrective actions, train staff, and support annual risk assessments. The position requires 3 years in ambulatory coding and strong knowledge of health information management and revenue cycle processes, with MS Office proficiency.

Qualifications

• 3 years of progressive experience in ambulatory coding and coding audits.
• Knowledge of CPT, ICD-10-CM, and HCPCS; familiarity with regulatory standards.
• Experience in health information management and revenue cycle processes.
• Knowledge of Stark Law, Anti-Kickback Statute, False Claims Act, HIPAA and HITECH.
• MS Office proficiency (Word, Excel, Outlook).

Responsibilities

• Perform prospective and retrospective coding audits and reviews of medical records and billing documentation.
• Conduct audits to assess compliance with EMTALA, HIPAA and related laws.
• Develop and implement corrective action plans with education and policy updates.
• Create training materials and deliver virtual sessions.
• Support annual risk assessments and ongoing monitoring for compliance.

Skills

Ambulatory Coding

Healthcare Compliance

CPT/ICD-10-CM

HCPCS

MS Office

Education

Bachelor's Degree or equivalent

Master's degree preferred

Tools

Microsoft Word

Excel

Outlook

Job description

Description

Additional Position Details:FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM

Starting Wage for this exempt position: $78,832.00-$108,409.60, depending on experience

PLEASE NOTE: This is a remote position. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include online training and working day-to-day operations during Pacific Standard business hours. Candidates must live within the United States, and due to our pay practices, we are not able to employ candidates living in some states.

Position Summary

The Compliance & Integrity Auditor and Analyst is responsible for ongoing auditing and monitoring activities related to Asante’s operational processes and internal controls. The Compliance & Integrity Auditor and Analyst performs prospective and retrospective coding audits, including review of the quality of medical record and billing documentation relating to inpatient and outpatient professional, technical and facility charges. The Compliance & Integrity Auditor and Analyst also performs other audits based upon the Compliance/Integrity Department’s annual risk assessment and compliance workplan to assess Asante’s compliance in other legal/regulatory risk areas such as EMTALA, HIPAA, and the Stark and Anti-Kickback statutes. This position also performs additional ad hoc audits at the direction of the Director/Chief Compliance & Privacy Officer.

In collaboration with other members of the Compliance/Integrity department and operational stakeholders, the Compliance & Integrity Auditor and Analyst helps develop and implement corrective action plans – creating or building upon existing internal controls. Such corrective action plans may include the creation of education/training materials, delivering virtual training sessions, creating or revising policies and procedures, and developing ongoing monitoring processes to continuously assess and mitigate compliance risks. This position also supports the ongoing compliance risk assessment process, informing the scope and risk areas covered in the annual workplan.

Position Qualifications

Required Experience

• 3 years of progressive experience in ambulatory coding, including healthcare compliance auditing experience.
• Current working knowledge of CPT, ICD-10-CM, and HCPCS coding and other coding-related regulatory standards requirements.
• Knowledge and experience in health information management and revenue cycle processes.
• Knowledge of federal and state healthcare compliance-related laws and regulations, specifically the Stark Law, Anti-Kickback Statute, Civil Monetary Penalty Law, False Claims Act, HIPAA, and HITECH.
• Working knowledge of Microsoft Office products, including Word, Excel, and Outlook

Education

• Bachelor's Degree or equivalent education and work experience is required
• Master's degree in relevant field- preferred

Certification/Licensure

• CCS: Certified Coding Specialist or CPC: Certified Professional Coder is required
• CPMA: Certified Professional Medical Auditor (AAPC)- preferred
• CHC: Compliance Healthcare Certification (HCCA)- preferred

Total Rewards

We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:

• Competitive Pay: Hourly and salaried positions earn market-based compensation.
• Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
• Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
• Paid Time Off: Generous ETO for part-time and above employees.
• Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
• Additional Benefits: Life insurance, disability coverage, and employee assistance programs.

At Asante, we are guided by our values:

Excellence - Respect - Honesty - Service - Teamwork

Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.