Remote Healthcare Compliance Auditor (Coding & Audits)

Cardinal Health; Jackson (MS); Remote; USD 80,000 - 105,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Access to wages before pay day with my

Flexible spending accounts (FSAs)

Short- and long-term disability

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Job summary

Cardinal Health is seeking a Compliance Auditor to conduct coding, documentation audits focused on Medical Oncology, Radiation Oncology and Urology services. You will apply advanced knowledge of CPT, HCPCS, ICD-10-CM and reimbursement methodologies to assess compliance and improve processes.

You will review claims, analyze trends, educate providers and staff, and collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams to mitigate risk.

Qualifications

• Advanced knowledge of CPT, HCPCS, ICD-10-CM and reimbursement methodologies.
• Experience in medical oncology, radiation oncology and urology coding audits.
• 4-8 years of experience; undergraduate degree preferred.

Responsibilities

• Conduct coding, billing, and documentation audits to identify compliance and reimbursement risks.
• Review medical records and claims for regulatory, payer, and organizational requirements.
• Analyze audit findings, identify trends and opportunities for improvement, and recommend corrective actions.
• Prepare audit reports and communicate findings to leadership, providers, coders, and operational stakeholders.
• Provide education and guidance to physicians, coders, and staff on coding, documentation, compliance requirements, and industry best practices.
• Research coding and documentation questions to support accurate code assignment and reimbursement.
• Assign and validate ICD-10-CM, CPT, HCPCS, and modifier usage for professional and facility services as applicable.
• Coordinate responses to external audit and medical record requests and ensure timely submission of required documentation.
• Maintain current knowledge of coding guidelines, payer policies, and healthcare regulations impacting Medical Oncology, Radiation Oncology, and Urology services.
• Collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams on monitoring activities and compliance initiatives.
• Perform other duties as assigned.

Skills

Healthcare coding knowledge

Auditing experience

Regulatory compliance

Communication skills

Education

Undergraduate degree

Coding certification (AAPC/AHIMA)

Job description

Cardinal Health is seeking a Compliance Auditor to conduct coding, documentation audits focused on Medical Oncology, Radiation Oncology and Urology services. You will apply advanced knowledge of CPT, HCPCS, ICD-10-CM and reimbursement methodologies to assess compliance and improve processes.

You will review claims, analyze trends, educate providers and staff, and collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams to mitigate risk.