Impactful Compliance Analyst: Coding & Audits

Wellpath; Franklin (TN); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

401k

Paid time off

Wellness program

Job summary

Wellpath seeks a Compliance Analyst to support coding compliance and audit programs in correctional health settings. You will perform entry- to intermediate-level coding reviews, focusing on CPT, HCPCS, ICD-10-CM, and modifiers, and help maintain audit documentation.

Responsibilities include data collection, monthly/quarterly reports, and collaboration with senior auditors. Ideal candidates have formal coding training (AAPC/AHIMA) and knowledge of Medicaid requirements.

Qualifications

• Formal coding training completed (AAPC/AHIMA).
• Experience with CPT, HCPCS Level II, ICD-10-CM and modifiers.
• Knowledge of Medicaid rules and regulatory guidelines.

Responsibilities

• Conduct routine coding reviews and audits for CPT/HCPCS/ICD-10-CM and modifiers.
• Collect, organize, and validate audit data and maintain workpapers.
• Prepare regular compliance reports and perform data analysis to identify risks.
• Assist vendor audits and educate stakeholders on findings and remediation.

Skills

CPT/HCPCS/ICD-10-CM knowledge

Data analysis

Coding audits

Education

Associate's degree in Health Information Management

Bachelor's degree preferred

Formal coding training program (AAPC/AHIMA)

Tools

EMR systems

Encoders

Claims/billing workflows

Job description

Wellpath seeks a Compliance Analyst to support coding compliance and audit programs in correctional health settings. You will perform entry- to intermediate-level coding reviews, focusing on CPT, HCPCS, ICD-10-CM, and modifiers, and help maintain audit documentation.

Responsibilities include data collection, monthly/quarterly reports, and collaboration with senior auditors. Ideal candidates have formal coding training (AAPC/AHIMA) and knowledge of Medicaid requirements.