P
Not Specified Permanent

Job detail

Compliance Auditor -Remote

Providence Health & Services

Renton, Washington, United States

Job description

Compliance Auditor - Remote

The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures.

Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle:

  • Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT.

This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager.

The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing line-item charges, Revenue Codes, CPT descriptions, status, orders, supporting documentation, and reimbursement etc. The auditor applies strong critical thinking and analytical skills to evaluate accuracy, identify discrepancies, and ensure compliance while completing focused audits.

Audit findings are presented in a collaborative manner (verbally and visually) looking to a common goal of reducing risk within Providence as a system.

Overpayments received in error are refunded following the CMS Voluntary Self Disclosure 60 Day Overpayment Rule.

This position works remotely and is open to candidates residing in:

  • Alaska
  • Washington
  • Montana
  • Oregon
  • California
  • Texas
  • New Mexico

Providence caregivers are not simply valued they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Required Qualifications:

  • Bachelor's Degree in Business, Healthcare, Finance, or similar field, Or 5 years of recent Hospital Billing auditing, Nurse Auditing, or Hospital billing and coding experience.
  • 5 years of recent Hospital billing auditing or Hospital coding experience.

Preferred Qualifications:

  • Upon hire: Coding Certification from American Health Information Management Association

Salary Range by Location:

AK: Anchorage: Min: $37.84, Max: $58.75

AK: Kodiak, Seward, Valdez: Min: $39.45, Max: $61.24

California: Humboldt: Min: $39.45, Max: $61.24

California: All Northern California - Except Humboldt: Min: $44.26, Max: $68.71

California: All Southern California - Except Bakersfield: Min: $39.45, Max: $61.24

California: Bakersfield: Min: $37.84, Max: $58.75

Montana: Except Great Falls: Min: $30.47, Max: $47.30

Montana: Great Falls: Min: $28.86, Max: $44.81

New Mexico: Min: $30.47, Max: $47.30

Oregon: Non-Portland Service Area: Min: $35.28, Max: $54.77

Oregon: Portland Service Area: Min: $37.84, Max: $58.75

Texas: Min: $28.86, Max: $44.81

Washington: Western: Min: $39.45, Max: $61.24

Washington: Southwest - Olympia, Centralia & Below: Min: $37.84, Max: $58.75

Washington: Eastern: Min: $33.67, Max: $52.28

Washington: South Eastern: Min: $35.28, Max: $54.77

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more.