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Compliance Medical Records Auditor
- Passaic, New Jersey, United States
- Passaic, New Jersey, United States
À propos
Independently conducts and documents compliance audits of medical records, coding, and billing in accordance with regulatory requirements, internal policies, and audit standards. Analyzes audit results to identify trends, root causes, and systemic risks; develops recommendations for corrective action and process improvement. Interprets federal and state healthcare regulations, payer policies, and internal compliance standards to ensure audit methodology and findings align with regulatory expectations. Develops audit tools and evaluation criteria for new or evolving compliance initiatives. Prepares comprehensive audit reports for leadership, including analyses, findings, risk implications, and recommended actions. Advises operational leaders, coders, and clinical teams on compliance risks, documentation requirements, and regulatory interpretations. Maintains and enhances the compliance audit database, ensuring accuracy, integrity, and accessibility of audit documentation. Collaborates with Compliance leadership to design and implement monitoring programs, training initiatives, and policy updates. Participates in compliance investigations, risk assessments, and special projects requiring analytical expertise. Performs other duties and projects as assigned.
You Are:
Genuinely passionate about customer service and exercise sound judgement and an ability to remain professional in all situations Able to demonstrate high level of attention to detail, excellent organizational skills and have the ability to multitask Able to thrive in a fast-paced environment, have a knack for prioritizing work with a structured approach, and enjoy providing world class customer service
To Ensure Success In This Role, You Must Have:
CPC, CCS‑P, RCC, RHIT/A, or equivalent by the American Academy of Professional Coders Certified Professional coder required. 5+ years of experience in healthcare coding, billing, auditing, and/or compliance preferred. Associate's or Bachelor's degree preferred; equivalent experience in healthcare compliance, auditing, or coding accepted. Advanced knowledge of CPT, ICD‑10, HCPCS, and payer reimbursement methodologies. Demonstrated ability to interpret regulations, analyze complex data, and exercise independent judgment. Proficiency in Microsoft Excel, Word, and audit management tools. Strong written and verbal communication skills, including the ability to prepare analytical reports and present findings to leadership. Ability to evaluate information, draw conclusions, and make recommendations based on regulatory standards and audit evidence. Knowledge of compliance program requirements, healthcare regulatory frameworks, and audit theory. Experience working with AI tools is a plus.
We Offer:
Comprehensive Medical, Dental and Vision coverages. Health Savings Accounts with employer funding. Wellness dollars 401(k) Employer Match Free services at any of our imaging centers for you and your immediate family.
Pay Range: $63,000.00 - $87,000.00 per year
Compétences linguistiques
- English
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