To support the Yale Medicine Administration, the full-time remote Compliance Auditor will coordinate and conduct medical billing audits across 18 clinical departments, ensuring compliance with coding and documentation standards while providing training and feedback to staff.
Key responsibilities
Complete audits of departmental compliance chart reviews and participate in third-party audits
Assess provider documentation for ICD-10 and CPT-4 coding accuracy and compliance with regulations
Conduct training sessions for physicians and departmental personnel on medical billing compliance
Required qualifications
CPC certification required, with the expectation to obtain it within 6 months to 1 year if not currently held
Bachelor's degree in Health Care Management, Finance, Business, Nursing, or a related field
Five years of experience in a multi-specialty group practice, academic plan, or hospital setting
Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices
Ability to interpret operative and procedural reports