Healthcare Compliance & Coding Auditor

Memorial Healthcare System; Florida; On-site; USD 75,000 - 105,000; Full time

Job summary

Memorial Healthcare System seeks an experienced Compliance Auditor to oversee coding accuracy for evaluation and management and procedures, ensuring adherence to official guidelines, medical necessity, and regulatory requirements.

The role includes preparing formal audit reports, conducting investigations, and monitoring compliance with laws and System policies, while educating staff on the Compliance Program and verifying documentation for ICD-10 coding and billing accuracy.

Qualifications

• Associates degree required.
• CCA or CPMA certifications required.
• Bachelor’s degree preferred.

Responsibilities

• Audit reports: prepare formal audit background, steps and findings for leadership and Board review.
• Participate in investigations and respond to inquiries by federal/state agencies.
• Monitor compliance with state/federal laws and System policies; identify deviations and recommend corrective action.
• Follow up on audit findings to ensure corrective actions are effective.
• Ensure compliance with regulatory agencies governing healthcare delivery, payers and accreditors.
• Educate employees on the Memorial Healthcare System Compliance Program.

Skills

Attention to detail

Analytical thinking

Regulatory knowledge

Auditing

Communication skills

Education

Associate degree in HIM

CCA Certification

CPMA Certification

CPC Certification

Job description

Memorial Healthcare System seeks an experienced Compliance Auditor to oversee coding accuracy for evaluation and management and procedures, ensuring adherence to official guidelines, medical necessity, and regulatory requirements.

The role includes preparing formal audit reports, conducting investigations, and monitoring compliance with laws and System policies, while educating staff on the Compliance Program and verifying documentation for ICD-10 coding and billing accuracy.