Compliance Auditor

Compliance Auditor Tennessee Orthopaedic Alliance - 2.6 Knoxville, TN Job Details 8 hours ago Benefits Paid holidays Dental insurance Paid time off Vision insurance 401(k) matching Qualifications Medicare Audit report preparation Maintaining patient confidentiality

CMS HIPAA

Healthcare documentation compliance audits Audit Reporting High school diploma or GED CMS regulatory compliance Documentation tools Health insurance knowledge Medicare regulations Video conferencing software Clinical information systems Centers for Medicare & Medicaid Services (CMS) billing regulations Medicaid regulations Productivity software Video conferences (communication methods) Clinical documentation standards Medical terminology Full Job Description Requirements Perform remote audits of primarily outpatient, professional fee, Orthopaedic coding auditing to include Orthopaedic surgery coding, some inpatient professional coding, Physical Therapy, and Occupational Therapy coding auditing, as well Review medical documentation for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Ensure compliance with CMS, Medicare, Medicaid, commercial payer, and organizational guidelines Identify coding trends, risks, and opportunities for improvement Prepare audit summaries, reports, and corrective action recommendations Provide virtual or in-person education and feedback to coders, physicians, and clinical staff Participate in compliance reviews and external audit responses Maintain detailed audit documentation and confidentiality standards Stay informed on coding updates, payer policy changes, and industry regulations Required Qualifications High school diploma or equivalent required 3-5+ years of medical coding and auditing experience Strong knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology Experience auditing electronic health records remotely Familiarity with CMS regulations and payer reimbursement methodologies Proficiency with EHR systems, encoder software, Microsoft Office, and remote communication tools Strong analytical, organizational, and written communication skills Ability to work independently in a remote environment Preferred Certifications One or more of the following certifications required: AAPC Certified Professional Coder (CPC) AAPC Certified Professional Medical Auditor (CPMA) AAPC Certified Professional Compliance Officer (CPCO) AHIMA Certified Coding Specialist (CCS) AHIMA Registered Health Information Administrator (RHIA) Remote Work Requirements Reliable high-speed internet connection Secure home office environment compliant with HIPAA standards Ability to participate in video meetings and remote collaboration Self-directed with strong time-management skills Compensation Typical salary depending on certifications, specialty experience, employer, and references. Benefits May Include Remote/work-from-home flexibility Health, dental, and vision insurance Paid time off and holidays Continuing education allowance Certification renewal assistance 401(k) with employer match Sample Skills Medical coding audits Clinical documentation review Remote collaboration Data analysis Provider education HIPAA compliance Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.