Revenue Compliance Auditor - Supervisor

Description Job Summary:

The Revenue Compliance Auditor is responsible for ensuring organizational adherence to regulatory, payer, and internal compliance requirements related to revenue cycle operations. This role conducts audits of billing, coding, and reimbursement processes to identify risks, prevent revenue leakage, and promote accurate and compliant financial practices.

Essential Functions:

Compliance Auditing & Monitoring

• Perform routine and targeted audits of billing, coding, and revenue cycle processes
• Evaluate compliance with federal, state, and payer regulations (e.g., Medicare, Medicaid, commercial payers) Risk Identification & Mitigation
• Identify trends, errors, and missed revenue opportunities
• Identify potential compliance risks
• Recommend corrective actions and process improvements Regulatory & Policy Adherence
• Stay current with healthcare regulations, reimbursement policies, and coding updates
• Ensure adherence to internal policies and external requirements
• Track payor fee schedule updates and timing for optimal billing and reimbursement Reporting & Documentation
• Prepare detailed audit reports with findings, risk levels, and recommendations
• Present audit results to leadership and relevant stakeholders
• Maintain accurate records of audits and compliance activities Education & Training
• Provide education to staff on documentation, coding, and billing compliance
• Support development of training materials and compliance resources Project Management and Team Supervisor/Manager
• Provide direction and education to additional team members
• Lead in weekly reporting meetings and recommendations for internal fee schedule updates Collaboration
• Partner with Revenue Cycle, Managed Care, Finance, and Compliance teams to resolve issues Other Duties as

Assigned:

Supervisory Responsibilities :

(Scope of the person's authority, including a list of jobs that report to this job)

None Essential Qualifications:

(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Licensure/Certification:

Bachelor's in Healthcare Administration or related field

• preferred. Certified Professional Coder (CPC)
• required Certified Healthcare Compliance (CHC)
• preferred

Required Knowledge:

Strong knowledge of medical coding (ICD-10, CPT, HCPCS) Strong understanding of OTP framework / MAT billing models Understanding of healthcare reimbursement methodologies Experience Required 3+ years of experience in healthcare revenue cycle, auditing, coding, or compliance.

• Direct experience with Opioid Treatment Programs (OTP) or substance use disorder services strongly preferred.

Experience with Medicare, Medicaid, Commercial, and Grant-funded programs. Experience with EHR systems and billing platforms

Skill and Ability:

Analytical and critical thinking skills. Attention to detail and accuracy. Strong written and verbal communication skills. Ability to interpret regulations and apply them operationally Job or State Requirements Bachelor's Degree in Healthcare Administration or related field preferred. Certified Professional Coder (CPC) required. Certified Healthcare Compliance (CHC) Preferred