Remote Compliance Auditor: Medical Billing & Coding

Thomas Jefferson University Hospital; Philadelphia (Philadelphia County); Remote; USD 70,000 - 100,000; Full time

Job summary

Thomas Jefferson University Hospital is seeking a Compliance Auditor to perform risk-based audits of clinical documentation, coding, and billing records. You will validate documentation, identify compliance risks, and support audit readiness across hospital and provider settings.

The role requires organizing audit work, meeting deadlines, and communicating findings to stakeholders. Strong knowledge of coding rules and regulations is essential, with Epic EHR experience preferred.

Qualifications

• Bachelor's degree required in health information management, healthcare administration, or related field.
• 3 years of progressive experience in coding and/or regulatory compliance auditing in healthcare.
• Experience performing provider-side and hospital-based documentation and coding audits preferred.

Responsibilities

• Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records.
• Evaluates accuracy of coding, billing, and documentation for medical necessity and compliance with laws.
• Conducts audits across professional fee, hospital, and specialty services; reviews inpatient, outpatient, and ancillary services.
• Identifies patterns and escalates compliance risks through governance channels.
• Supports audit plans and responses to external government and payer reviews.
• Maintains audit workpapers and prepares concise reports for Compliance leadership.

Skills

Audit planning

Regulatory compliance

Communication

Education

Bachelor's degree in Health Information Management or related field

Tools

Epic EHR

Job description

Thomas Jefferson University Hospital is seeking a Compliance Auditor to perform risk-based audits of clinical documentation, coding, and billing records. You will validate documentation, identify compliance risks, and support audit readiness across hospital and provider settings.

The role requires organizing audit work, meeting deadlines, and communicating findings to stakeholders. Strong knowledge of coding rules and regulations is essential, with Epic EHR experience preferred.