Senior Billing Compliance Auditor (Hybrid/Remote)

NorthShore University HealthSystem; Evanston (IL); Hybrid; USD 41,328 - 63,369; Full time

Benefits offered by this job

Annual increases based on performance

Career pathways for growth

Medical, dental, vision options

Tuition reimbursement

Free parking

Wellness program savings

Health Savings Account options

Retirement options with company match

Paid time off & holidays

Job summary

NorthShore University HealthSystem is seeking a Senior Auditor for Billing Compliance to conduct audits, analyze coding and billing documentation, and support investigations across the medical group and system facilities. The role requires strong knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Medicare/Medicaid rules, with EPIC experience highly preferred.

Hybrid work arrangement (Evanston, IL and remote) with flexible hours and opportunity for professional growth within a leading health system.

Qualifications

• Bachelor's degree required and RHIA/RHIT or nursing with coding certification (CCS, CPC) desired.
• 3+ years in regulatory billing compliance and hospital/professional revenue cycle.
• Experience with EPIC strongly preferred.

Responsibilities

• Conduct comprehensive retrospective and prospective coding, billing, and documentation audits.
• Analyze notes and billing docs to ensure coding accuracy and regulatory compliance.
• Audit ICD-10-CM, CPT/HCPCS codes for appropriateness against records and rules.
• Lead internal investigations related to billing concerns and external inquiries.
• Identify trends and risks; communicate findings and drive corrective actions.
• Document audit activities and support regulatory readiness.
• Calculate reimbursement impact and overpayment estimates using Excel.
• Support audit responses with data validation and documentation.
• Communicate results across clinical, operational, and compliance teams.
• Maintain current knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Medicare updates.

Skills

medical coding

compliance research

investigative analysis

CMS policy interpretation

Excel (data analysis, pivot, VLOOKUP/X

Microsoft Word

Education

Bachelor's degree

Tools

EPIC

Job description

NorthShore University HealthSystem is seeking a Senior Auditor for Billing Compliance to conduct audits, analyze coding and billing documentation, and support investigations across the medical group and system facilities. The role requires strong knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Medicare/Medicaid rules, with EPIC experience highly preferred.

Hybrid work arrangement (Evanston, IL and remote) with flexible hours and opportunity for professional growth within a leading health system.