CPC Certified Compliance Auditor

Job Summary

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