To support the Yale Medicine Administration, the full-time remote CPC Certified Compliance Auditor will coordinate and conduct medical billing audits, evaluate coding and documentation across clinical departments, and provide training to physicians and staff.
Key responsibilities
Complete audits of departmental compliance chart reviews and participate in audits requested by third-party payors
Assess provider documentation for ICD-10 and CPT-4 coding accuracy and compliance with regulations
Conduct training sessions on medical billing compliance and develop educational materials for clinical and billing staff
Required qualifications
CPC certification required, or expected to be obtained within 6 months to 1 year after hire
Bachelor's degree in Health Care Management, Finance, Business, Nursing, or a related field
Five years of experience in multi-specialty group practice, academic plan, or hospital
Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices
Ability to interpret operative and procedural reports