Senior Compliance Auditor

VCU Health; United States; Remote; USD 75,000 - 100,000; Full time

Job summary

VCU Health is seeking a Senior Compliance Auditor to review complex audits, perform quality assurance, and assist in onboarding new auditors. This remote position requires a bachelor's degree, relevant certifications, and at least five years of experience in healthcare auditing and coding.

Qualifications

• Minimum of five years of progressive healthcare experience.
• Experienced in auditing medical records and understanding diagnostic and procedural codes.
• Current AAPC or AHIMA certification required.

Responsibilities

• Review complex audits and perform quality assurance reviews.
• Support audit manager with development of the quarterly audit work plan.
• Conduct documentation/chart audits on inpatient and outpatient records.

Skills

Problem Solving

Quality Assurance

Data Collection

Education

Bachelor’s Degree in Business, Finance, Allied Health, or related field

Tools

Microsoft Office

Job description

Remote opportunity in the following locations: VA, MD, WV, NC, SC, GA, FL, TN, KY, AR, AL, MI, OH, KS, MO, TX

The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding new auditors.

The Senior Compliance Auditor supports the audit manager with the development and maintenance of the quarterly audit work plan and audit workflow processes. This role involves recommending improvements to business operations using professional judgment and best practices. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, providing analysis, education, and assistance as needed.

The Senior Compliance Auditor audits VCUHS coding and billing (DRG, CPT, ICD-10) based on review of medical record documentation and billing claim data.

Licensure, Certification, or Registration Requirements for Hire:

• One (1) of the following current AAPC certifications: CPC, CPC-H, CPC-P, CPMA
• OR one (1) of the following current AHIMA certifications: CCA, CCS, CCS-P
• OR other current coding-related certification

Requirements for Continued Employment:

• Same certifications as above

Experience REQUIRED:

• Minimum of five (5) years of progressive healthcare experience, including working with electronic health records, auditing medical records, and understanding diagnostic and procedural codes.
• Experience with Microsoft Office and data collection tools.

Preferred Experience:

• Seven (7) years in coding review, five (5) years in hospital/physician training.

Education/Training REQUIRED:

• Bachelor’s Degree in Business, Finance, Allied Health, or related field.

Additional Information:

• Utilizes high self-direction, takes initiative, minimal supervision required.
• Physical activities include sitting, walking, reaching; physical lifting less than 20 lbs.
• Mental skills include recall, reasoning, problem solving, reading, and logical thinking.
• Work environment is fast-paced, requires adaptability and handling multiple priorities.

This position is remote/hybrid.

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.