Healthcare Compliance Auditor: Coding & Documentation

jeffersonhealth; Philadelphia (Philadelphia County); On-site; USD 70,000 - 110,000; Full time

Job summary

Jefferson Health is seeking a Compliance Auditor to conduct risk-based audits of clinical documentation, coding, and billing records to ensure compliance with regulations and internal policies. The role requires independent management of audit workload, documentation, and deadlines in a hospital and provider-based setting.

Responsibilities include evaluating coding accuracy, medical necessity, and adherence to payer requirements; performing audits across professional, hospital, and specialty

Qualifications

• Bachelor's degree in health information management, healthcare administration, or related field.
• 3 years of progressive experience in coding or regulatory compliance auditing in healthcare.
• Experience auditing provider-side and hospital-based documentation and coding preferred.

Responsibilities

• Audit clinical documentation, coding, and billing records for compliance.
• Evaluate coding accuracy, medical necessity, and adherence to payer requirements.
• Prepare audit reports detailing findings, risks, and recommendations.
• Collaborate with Revenue Cycle, Coding, and operations to support compliance objectives.
• Support external audit readiness and responses to regulatory reviews.

Skills

Regulatory knowledge

Audit analysis

Communication skills

Independent judgment

Project management

Education

Bachelor's in HIM/Healthcare Admin

Tools

Epic EHR

Job description

Jefferson Health is seeking a Compliance Auditor to conduct risk-based audits of clinical documentation, coding, and billing records to ensure compliance with regulations and internal policies. The role requires independent management of audit workload, documentation, and deadlines in a hospital and provider-based setting.

Responsibilities include evaluating coding accuracy, medical necessity, and adherence to payer requirements; performing audits across professional, hospital, and specialty