CPC Certified Compliance Auditor

Job Summary

To support the Yale Medicine Administration, the full-time remote Compliance Auditor will coordinate and conduct medical billing audits across 18 clinical departments, ensuring compliance with coding and documentation standards while providing training and feedback to staff.

Key responsibilities

• Complete audits of departmental compliance chart reviews and participate in third-party audits
• Assess provider documentation for ICD-10 and CPT-4 coding accuracy and compliance with regulations
• Conduct training sessions for physicians and departmental personnel on medical billing compliance

Required qualifications

• CPC certification required, with the expectation to obtain it within 6 months to 1 year if not currently held
• Bachelor's degree in Health Care Management, Finance, Business, Nursing, or a related field
• Five years of experience in a multi-specialty group practice, academic plan, or hospital setting
• Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices
• Ability to interpret operative and procedural reports