Remote Claims Audit Supervisor - Lead QA & Compliance

Cardinal Health; Boise (ID); On-site; USD 69,000 - 88,000; Full time

Benefits offered by this job

Medical/dental/vision

Paid time off

Health savings account

401k savings plan

Early wage access

FSAs

Disability coverage

Work-life resources

Parental leave

Wellness programs

Job summary

Cardinal Health seeks an Audit & Compliance Lead within Revenue Cycle Management to oversee audit programs, ensure regulatory compliance across Medicare/Medicaid, and drive process improvements across the organization.

You will manage the Audit team, coordinate with payors, and produce action reports while guiding best practices for documentation, denials, and timely responses to inquiries. This role emphasizes accuracy, compliance, and cross-functional collaboration.

Qualifications

• 4-8 years of experience, preferred.
• Bachelor's degree in related field, or equivalent work experience, preferred.
• Leadership, project management, or supervisory experience preferred.
• Urology or wound care product knowledge preferred.

Responsibilities

• Oversee the Audit team and respond to all audit requests in a timely manner; develop and implement audit processes.
• Focus on quality assurance, quality improvement, and compliance with Federal and State regulations.
• Lead team reviewing validity of clinical documentation for accuracy and compile response packets for audits.
• Provide feedback on successes and failures monthly; cover areas related to audit/recoupment inquiries and payor collections.
• Oversee all aspects of a TPE, CERT, RAC, pre/post payment, or 3rd party audit and respond within required timeframes.
• Oversee all aspects of a Recoupment or Refund request and respond within required time frames.
• Monitor, track, and trend all audits; gather and review documentation for audits, recoupments, or other requests.
• Communicate with CMS and other auditors regularly; ensure audits meet legal and policy requirements.

Skills

Leadership

Project management

Supervisory experience

Urology knowledge

Wound care knowledge

Education

Bachelor's degree in related field

Job description

Cardinal Health seeks an Audit & Compliance Lead within Revenue Cycle Management to oversee audit programs, ensure regulatory compliance across Medicare/Medicaid, and drive process improvements across the organization.

You will manage the Audit team, coordinate with payors, and produce action reports while guiding best practices for documentation, denials, and timely responses to inquiries. This role emphasizes accuracy, compliance, and cross-functional collaboration.