Remote Billing & Coding Compliance Auditor II

Stanford Health Care; Sacramento (CA); On-site; USD 72,000 - 96,000; Full time

Job summary

Stanford Health Care seeks a Billing and Coding Compliance Auditor to conduct proactive audits, review documentation for regulatory compliance, and collaborate across departments to mitigate risks. The role involves evaluating ICD, CPT, HCPCS codes and E/M criteria, with a focus on accuracy and reimbursement integrity.

Requirements include an Associate’s degree and at least four years of related experience; professional coding certifications are preferred and must be obtained within 180 days.

Qualifications

• Associate’s degree in a work-related discipline/field is required.
• Minimum four (4) years of progressively responsible directly related work experience required.
• CCS/CCS-P/CPC/CIC/COC/CHC certifications are preferred or must be obtained within 180 days.

Responsibilities

• Initiate and perform proactive coding and billing audits to identify potential errors and ensure compliance.
• Utilize auditing software to streamline processes and improve data analysis.
• Monitor billing and coding data for patterns of non-compliance and assess medical services for accuracy in ICD/HCPCS/CPT and E/M coding.
• Review documentation supporting billed services to ensure accuracy and identify compliance risks.
• Conduct investigations into billing and coding compliance issues and prepare detailed audit reports with recommendations.

Skills

Attention to detail

Analytical thinking

Communication skills

Leadership in issue resolution

Critical thinking

Education

Associate’s degree in a work-related discipline/field

Tools

EPIC

3M

Excel

PowerPoint

Job description

Stanford Health Care seeks a Billing and Coding Compliance Auditor to conduct proactive audits, review documentation for regulatory compliance, and collaborate across departments to mitigate risks. The role involves evaluating ICD, CPT, HCPCS codes and E/M criteria, with a focus on accuracy and reimbursement integrity.

Requirements include an Associate’s degree and at least four years of related experience; professional coding certifications are preferred and must be obtained within 180 days.