Senior Integrity Auditor

University Health; San Antonio (TX); On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Competitive compensation

Benefits package

Job summary

University Health in San Antonio is seeking a Senior Integrity Auditor to strengthen our Compliance team. The role focuses on analytical auditing, monitoring activities, and supporting the Compliance Work Plan under the Chief Compliance/HIPAA Officer.

You will conduct audits across coding, billing, medical record documentation, claims, and clinical data, review revenue cycle controls, and generate detailed reports while maintaining integrity and confidentiality.

Qualifications

• Bachelor's degree preferred and professional certifications required (AAPC or AHIMA).
• Minimum of three years in audit functions, preferably in outpatient/ASC environments.
• Expert knowledge of ICD, CPT, HCPCS, DRG, APC, ASC payment methodologies and claims validation.

Responsibilities

• Perform audits in coding, billing, medical record documentation, claims, and clinical data.
• Review revenue cycle and internal controls to prevent/detect errors, fraud, waste, and abuse.
• Assist in audits/investigations with approval from Chief Compliance/HIPAA Officer.
• Generate detailed reports on findings and compliance concerns.
• Maintain relationships with stakeholders and uphold integrity and confidentiality.
• Champion compliance, accuracy, and ethical standards across the organization.

Skills

ICD, CPT, HCPCS coding classifications

DRG, APC, ASC payment methodologies

Claims validation reviews

Education

Bachelor's degree (preferred)

CPC, CPMA, CCS, RHIA, RHIT certifications

Job description

Position Summary:

University Health is seeking a dedicated and detail-oriented Senior Integrity Auditor to join our Compliance team. This pivotal role is responsible for leveraging departmental resources to conduct analytical auditing and monitoring activities to support our comprehensive compliance program.

The Senior Integrity Auditor will work under the supervision of the Chief Compliance/HIPAA Officer to assist in the development and execution of the Compliance Work Plan. The auditor conducts complex operational and compliance audits from inception to completion, ensuring alignment with departmental practices and regulatory standards.

Key Responsibilities:

• Perform audits and reviews in areas such as coding, billing, medical record documentation, claims, and clinical data.
• Routinely review University Health’s revenue cycle and internal control structures to prevent and detect errors, fraud, waste, and abuse.
• Assist in other audits and investigations with approval from the Chief Compliance/HIPAA Officer.
• Generate detailed reports related to findings and compliance concerns.
• Maintain strong relationships with internal and external stakeholders while upholding the highest standards of integrity and confidentiality.
• Serve as a champion for compliance, accuracy, and ethical standards across the organization.

Qualifications:

• Bachelor's degree from an accredited college or university strongly preferred.
• Certification required from one or more of the following:
  • AAPC (CPC, CPMA)
  • AHIMA (CCS, RHIA, RHIT)
• Minimum of three (3) years of experience in audit functions, with a strong preference for experience in multi-specialty outpatient or Ambulatory Surgery Center environments.
• Expert knowledge in:
  • ICD, CPT, HCPCS coding classifications
  • DRG, APC, and ASC payment methodologies
  • Ability to perform claims validation reviews and apply regulatory standards with credibility and objectivity.

Why University Health?

• A mission-driven organization that values innovation, diversity, and excellence.
• Competitive compensation and benefits package.
• Opportunity to work alongside industry leaders in a collaborative and supportive environment.