Senior Billing Compliance Auditor - Hybrid Role

Nevada System of Higher Education; Evanston (IL); Hybrid; USD 41,000 - 63,000; Full time

Benefits offered by this job

Annual increases based on performance

Tuition Reimbursement

Free Parking

Health Savings Account Options

Retirement Options with Company Match

Paid Time Off and Holiday Pay

Wellness Program Savings Plan

Community Involvement Opportunities

Job summary

Endeavor Health is seeking a Billing Compliance Senior Auditor in Evanston, IL for a hybrid, full-time role. You will conduct comprehensive audits of coding and billing across facilities, ensuring accuracy and regulatory compliance with payer rules.

You will analyze medical records, lead investigations, and identify trends and risks, while maintaining thorough documentation and supporting external audits. Proficiency in Excel and Medicare/Medicaid guidelines is essential.

Qualifications

• Bachelor's degree required.
• RHIA or RHIT or nurse with coding certification (CCS, CPC) required.
• 3+ years in regulatory billing compliance and revenue cycle.

Responsibilities

• Conduct audits of coding, billing, and documentation across the medical group.
• Analyze source documents to ensure coding and billing accuracy.
• Audit ICD-10-CM, CPT/HCPCS codes for appropriateness per policies and regulations.
• Lead internal compliance investigations and respond to inquiries.
• Identify trends and risks in coding and billing practices; escalate as needed.
• Maintain audit documentation and corrective action plans.
• Calculate reimbursement impact using Excel with data mining techniques.
• Support external audits with documentation and data validation.
• Communicate audit results across clinical, operational, and compliance teams.
• Stay current with ICD-10-CM/PCS, CPT/HCPCS, and Medicare updates.

Skills

Auditing expertise

Coding compliance

Data analysis

Education

Bachelor's degree

RHIA/RHIT or CCS/CPC certification

Tools

Epic Billing

Excel

Billing software

Job description

Endeavor Health is seeking a Billing Compliance Senior Auditor in Evanston, IL for a hybrid, full-time role. You will conduct comprehensive audits of coding and billing across facilities, ensuring accuracy and regulatory compliance with payer rules.

You will analyze medical records, lead investigations, and identify trends and risks, while maintaining thorough documentation and supporting external audits. Proficiency in Excel and Medicare/Medicaid guidelines is essential.