Enterprise Provider Compliance Auditor-Educator
Core
Conducts compliance audits, reviews medical records and billing, and develops educational programs to ensure healthcare providers adhere to federal regulations and prevent fraud, waste, and abuse.
Role type
Senior compliance auditor and educator (healthcare)
Builds
Compliance audit reports, corrective action plans, and training curricula for medical staff
Domain
Healthcare administration and regulatory compliance
Required skills
Healthcare compliance auditing, medical coding (E&M, procedural/surgical), regulatory research, audit sampling, report writing, training facilitation, policy development, EMR/billing system analysis
Preferred skills
Bachelor's degree, CPC, RHIT, or CCS-P certification
Technologies
Electronic medical record systems, billing software, data analytics tools
Responsibilities
Conduct compliance audits and reviews of chart documentation and billing; Develop and deliver training sessions on compliance regulations and coding guidelines; Analyze complex EMR workflows to identify documentation and billing issues; Formulate audit scope and objectives with leadership; Compile compliance statistics and findings for executive reporting; Review new regulations to determine applicability to provider groups.
Seniority
Senior, hands-on IC
