Healthcare Compliance Auditor—Oncology Coding

Cardinal Health; Oregon; Ibrido; USD 80.000 - 105.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental and vision coverage

Paid time off plan

Health savings account

Descrizione del lavoro

Cardinal Health is seeking a Compliance Auditor to perform coding, documentation audits and education across Medical Oncology, Radiation Oncology and Urology services. The role emphasizes expertise in CPT, HCPCS, ICD-10-CM, reimbursement methodologies and healthcare regulations.

The ideal candidate will analyze complex claims, identify risks, and deliver actionable recommendations, fostering collaboration with physicians, coders and operational teams to improve compliance and billing accuracy.

Competenze

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

Mansioni

• 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.

Conoscenze

Experience (4-8 yrs)

Formazione

Undergraduate degree, preferred

Descrizione del lavoro

Cardinal Health is seeking a Compliance Auditor to perform coding, documentation audits and education across Medical Oncology, Radiation Oncology and Urology services. The role emphasizes expertise in CPT, HCPCS, ICD-10-CM, reimbursement methodologies and healthcare regulations.

The ideal candidate will analyze complex claims, identify risks, and deliver actionable recommendations, fostering collaboration with physicians, coders and operational teams to improve compliance and billing accuracy.