Strategic Billing & Coding Compliance Auditor II

Stanford Health Care; United States; Remote; USD 73,000 - 96,000; Full time

Job summary

Stanford Health Care is seeking a Billing and Coding Compliance Auditor to perform audits, assess documentation for ICD, CPT, HCPCS, and DRG/APC assignments, and ensure regulatory adherence. The role involves collaboration with Billing and Coding educators and cross-functional teams to mitigate compliance risks.

Responsibilities include conducting investigations, preparing detailed reports, and staying current with federal, state, and payer regulations.

Qualifications

• Associate degree or equivalent required.
• Minimum four years of related work experience.
• EPIC EHR experience preferred.
• Knowledge of ICD-10-CM/PCS, HCPCS, CPT.
• Ability to lead in problem solving and data-driven decisions.

Responsibilities

• Initiate proactive coding and billing audits to identify errors before claims submission.
• Use auditing software to streamline processes and improve data analysis.
• Monitor billing/coding data for patterns and assess regulatory compliance.
• Review documentation to ensure accuracy and adherence to coding guidelines.
• Conduct investigations into compliance issues and document findings and recommendations.

Skills

Effective communication

Critical thinking

Leadership in problem solving

Regulatory knowledge

Adaptability to priorities

Education

Associate's degree in a related field

Tools

EPIC EHR

3M

Microsoft Word

Excel

PowerPoint

Job description

Stanford Health Care is seeking a Billing and Coding Compliance Auditor to perform audits, assess documentation for ICD, CPT, HCPCS, and DRG/APC assignments, and ensure regulatory adherence. The role involves collaboration with Billing and Coding educators and cross-functional teams to mitigate compliance risks.

Responsibilities include conducting investigations, preparing detailed reports, and staying current with federal, state, and payer regulations.