Provider Compliance Auditor & Educator

WVU Medicine; Bensley (VA); On-site; USD 90,000 - 120,000; Full time

Job summary

West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support ongoing auditing, monitoring, and education across WVUHS and affiliates. The role ensures provider organizations meet CMS, state, and payer regulations, with emphasis on documentation, coding accuracy, and medical necessity.

The incumbent will lead audits, prepare comprehensive reports, and deliver education programs for physicians, APPs, and staff.

Qualifications

• High School Diploma or Equivalent and seven years of multi-specialty coding, E/M coding, or procedural coding experience.
• Associate’s Degree and five years of multi-specialty coding, E/M coding, or procedural coding experience.
• Current certification in CPC, RHIT, or CCS-P from AHIMA or AAPC.

Responsibilities

• Conducts compliance-related audits and reviews across WVUHS and affiliates.
• Develops audit reports outlining findings, recommendations, and corrective actions.
• Leads meetings to review audit results and implement corrective action plans.
• Plans and conducts internal and external compliance education and training programs.
• Assists in compilation of compliance statistics and reports for leadership.

Skills

Multi-specialty coding

E/M coding

Procedural coding

Medical coding experience

Education

High School Diploma or Equivalent

Associate’s Degree

Bachelor’s Degree

Job description

West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support ongoing auditing, monitoring, and education across WVUHS and affiliates. The role ensures provider organizations meet CMS, state, and payer regulations, with emphasis on documentation, coding accuracy, and medical necessity.

The incumbent will lead audits, prepare comprehensive reports, and deliver education programs for physicians, APPs, and staff.