State Licensed Compliance Auditor

Job Summary

To ensure compliance with federal, state, and regulatory requirements, the full-time Sr Compliance Auditor will lead and conduct audits of diagnostic and procedure codes, evaluate clinical documentation, and prepare detailed audit reports while communicating findings to management and healthcare providers.

Key responsibilities

• Lead continuous audits focusing on anesthesia documentation, billing, and coding compliance
• Evaluate clinical documentation to validate compliance with coding and billing laws and guidelines
• Prepare and present audit reports, and develop training programs based on audit findings

Required qualifications

• High school diploma required; associate or bachelor's degree in a related field preferred
• 7+ years of anesthesia coding experience or equivalent education and coding experience
• Certification in medical coding (Certified Professional Coder or Certified Coding Specialist) required
• Expert knowledge of CPT, ASA, and ICD-10 coding, as well as billing rules applicable to anesthesia
• Strong understanding of auditing methodologies and compliance frameworks