Healthcare Compliance Auditor: Coding & Audit Expert

Cardinal Health; United States; Presencial; USD 80 000 - 105 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, dental and vision coverage

401k savings plan

Paid time off

Resumo da oferta

Cardinal Health is seeking a Compliance Auditor to perform coding, documentation, and billing audits ensuring adherence to regulatory requirements, payer policies, and internal standards. Focus areas include Medical Oncology, Radiation Oncology, and Urology services with advanced CPT/HCPCS/ICD-10-CM knowledge.

The role requires strong attention to detail, ability to identify regulatory risks, and collaboration with clinical and operational teams to drive improvement and education across the

Qualificações

• Coding certification from an accredited source (AAPC, AHIMA, etc.)
• 4-8 years of experience, preferred
• Undergraduate degree, preferred

Responsabilidades

• Conduct coding, billing, and documentation audits to identify compliance, coding, and reimbursement risks.
• Review medical records and claims to ensure compliance with regulatory, payer, and organizational requirements.
• Analyze audit findings, identify trends and opportunities for improvement, and recommend corrective actions.
• Prepare audit reports and communicate findings to leadership, providers, coders, and operational stakeholders.
• Provide education and guidance to physicians, coders, and staff on coding, documentation, compliance requirements, and industry best practices.
• Research coding and documentation questions to support accurate code assignment and reimbursement.
• Assign and validate ICD-10-CM, CPT, HCPCS, and modifier usage for professional and facility services as applicable.
• Coordinate responses to external audit and medical record requests and ensure timely submission of required documentation.
• Maintain current knowledge of coding guidelines, payer policies, and healthcare regulations impacting Medical Oncology, Radiation Oncology, and Urology services.
• Collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams on monitoring activities and compliance initiatives.
• Perform other duties as assigned.

Conhecimentos

Coding certification

Auditing experience

Healthcare regulations

Formação académica

Undergraduate degree

Ferramentas

CPT coding

HCPCS coding

ICD-10-CM

Descrição da oferta de emprego

Cardinal Health is seeking a Compliance Auditor to perform coding, documentation, and billing audits ensuring adherence to regulatory requirements, payer policies, and internal standards. Focus areas include Medical Oncology, Radiation Oncology, and Urology services with advanced CPT/HCPCS/ICD-10-CM knowledge.

The role requires strong attention to detail, ability to identify regulatory risks, and collaboration with clinical and operational teams to drive improvement and education across the