- Salary
- $17+
- Location
- Clinton, Missouri
- Workplace
- Remote
- Type
- Full-time
- Department
- Finance
- Education
- High School
- Source
- Pinpoint
Description
Compliance Auditor
Department: Compliance
Employment Type: Full Time
Location: Any Compass Location
Compensation: $17.89 / hour
Description
*Remote position open to Missouri residents only.
Key Responsibilities
- · Audits service documentation for completeness, accuracy and compliance with payer requirements
- Utilizes audit tool software to conduct audits, document findings and support audit activities
- Collaborates with internal audit staff on joint projects and identifies and communicates opportunities to improve audit processes
- Educates providers on audit findings and communicates results clearly, concisely and accurately
- Analyzes anomalies identified through audit processes and escalates findings for further review as appropriate
- Applies program-specific regulatory requirements and dual-program audit procedures when conducting audits
- Performs audit activities in accordance with established efficiency standards and expectations set by Audit Services leadership
- Meets regularly with Compliance and Audit leadership to discuss audit findings, processes, priorities and opportunities for improvement
- Evaluates the impact of clinical and operational changes on audit processes and implements or recommends actions to mitigate identified risks
- Participates in the review and resolution of claim rejections and reimbursement discrepancies in collaboration with Patient Accounting to support accurate reimbursement and regulatory compliance
- Monitors documentation trends, identifies potential deficiencies and compliance concerns, and reports findings to appropriate personnel
- Conducts follow-up clinical documentation improvement education based on audit findings and results
- Reviews medical codes using ICD-10 and CPT coding systems to assess coding accuracy and compliance with applicable requirements
- Extracts and analyzes reports from applicable electronic health record (EHR) systems to support auditing, monitoring and reporting activities
- Performs other duties as assigned
Requirements, Skills, Knowledge and Expertise
- High School/GED required
- At least one (1) year of medical terminology preferred
- Must have experience working collaboratively with diverse groups in a healthcare environment
- Must be familiar with government healthcare reimbursement systems
- Experience in ICD, DSM V, and Excel preferred
- Are detail-oriented and highly organized, with the ability to manage multiple priorities effectively
- Enjoy working both independently and collaboratively to improve processes and outcomes
- Can interpret data and identify patterns that support compliance and operational improvement
- Communicate clearly and professionally with clinical and administrative teams
- Value accuracy, accountability, and continuous learning in a healthcare environment
- Are passionate about supporting quality care and strengthening services for rural communities through strong documentation and compliance practices