- Pensacola, Florida, United States
- Entry
- 5+ years
Entry‑level compliance auditor responsible for auditing outpatient and professional services claims to federally funded healthcare payors.
Responsibilities
- Perform routine and targeted audits of patient services and corresponding claims submitted to government payors
- Audit outpatient/ambulatory cases for ICD‑10, CPT, and other coding accuracy
- Review and abstract physician documentation for diagnoses, procedures, and ancillary services
- Develop and maintain comprehensive audit reports and documentation
- Present audit findings and recommendations to audited providers and department leadership
Requirements
- Bachelor's Degree Health Information Management, Related field
- Nice to have: 1 year healthcare coding and billing experience
- Nice to have: Healthicity
- Nice to have: Electronic Health Records (Altera Sunrise, Epic)
- Nice to have: Hyland MRM