Healthcare Compliance Auditor & Educator

WVU Medicine; Uniontown (Fayette County); On-site; USD 75,000 - 110,000; Full time

Job summary

WVU Medicine is seeking an Enterprise Compliance Auditor/Educator to ensure alignment with federal healthcare program rules and state regulations. You will assist in policy development, monitoring, and attend meetings representing the Compliance Department.

The role requires partnering with leadership to define audit scope, conduct independent audits, and communicate findings. You will guide corrective actions and provide education to departments across the system.

Qualifications

• High School diploma or equivalent with 5 years in healthcare revenue cycle or Bachelor's + 2 years in healthcare revenue cycle
• Experience with hospital regulatory/payor guidelines preferred

Responsibilities

• Participates in annual and ongoing regulatory risk assessment and compliance work plan
• Defines scope and objectives of audits with Hospital Compliance Director and VP
• Assesses audit scope and develops data analytics reports to identify the audit universe and sample
• Communicates with executives, management and staff; documents interactions for formal reporting
• Conducts compliance audits; prepares formal reports and corrective actions; coordinates with WVUHS entities
• Supports revenue integrity through charge capture, coding principles, and billing policy analysis
• Performs regulatory research to apply to audit samples
• Reviews medical record billing and related documentation
• Authours and submits audit summaries to enterprise board committees with findings and corrective actions
• Leads meetings to review reports and develop corrective action plans
• Delivers educational activities and trainings for Corporate Compliance
• Plans and presents educational sessions; serves as compliance representative on teams or committees

Skills

Organizational skills

Communication skills

Presentation skills

EMR/billing systems

Independent work

Education

High School diploma or equivalent

Bachelor's degree

Job description

WVU Medicine is seeking an Enterprise Compliance Auditor/Educator to ensure alignment with federal healthcare program rules and state regulations. You will assist in policy development, monitoring, and attend meetings representing the Compliance Department.

The role requires partnering with leadership to define audit scope, conduct independent audits, and communicate findings. You will guide corrective actions and provide education to departments across the system.