Provider Compliance Auditor & Educator

WVU Medicine; Morgantown (WV); On-site; USD 65,000 - 95,000; Full time

Job summary

SYSTEM West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support audits, education, and monitoring across WVUHS and affiliates. The role focuses on CMS, state, and payor regulations to ensure compliant chart documentation, coding, and reimbursement.

Responsibilities include developing audit reports, coordinating corrective actions, delivering training, and partnering with compliance leaders to educate staff and physicians.

Qualifications

• Education, certification, and/or licensure requirements as stated.
• Understanding of CMS, multistate regulations, and payor rules.
• Ability to review medical records, coding, and billing for accuracy.

Responsibilities

• Conducts compliance-related audits and reviews across WVUHS and affiliates.
• Develops audit reports with findings and corrective actions.
• Leads meetings to review reports and implement action plans.
• Plans and conducts internal and external compliance presentations.
• Coordinates education to meet organizational compliance needs.
• Facilitates audit training and education activities.
• Reviews clinical documentation to ensure proper coding and reimbursement.

Skills

Auditing

Compliance

Education delivery

Communication

Presentation skills

Problem solving

EMR systems

Education

High School Diploma or Equivalent

Associate’s Degree

Bachelor’s Degree

CPC certification

RHIT certification

CCS-P certification

Job description

SYSTEM West Virginia University Health System is seeking an Enterprise Compliance Auditor/Educator to support audits, education, and monitoring across WVUHS and affiliates. The role focuses on CMS, state, and payor regulations to ensure compliant chart documentation, coding, and reimbursement.

Responsibilities include developing audit reports, coordinating corrective actions, delivering training, and partnering with compliance leaders to educate staff and physicians.