Medical Coding Compliance Auditor

🔥 26 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 10%

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VMG Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1995

🏥 Healthcare

💼 Consulting

☁️ SaaS

💰 Private equity on 2020-04

Healthcare • Consulting • SaaS

VMG Health is a healthcare-focused consulting firm with three decades of experience that provides advisory, operational, compliance, valuation, and transaction services to healthcare organizations. The firm offers M&A and transaction advisory, valuation advisory, coding audit and compliance, strategy and operational performance consulting, physician enterprise solutions, litigation and dispute resolution support, and specialized expertise in ophthalmology and eyecare. VMG also develops software and analytics products (e. g. , Compliance Risk Analyzer®, FMV-MD®, Intellimarker®) and membership programs to support client performance. The company serves clients across all 50 states, employs 300+ professionals, and recently acquired Community Link Consulting.

📋 Description

• Provide auditing, compliance, education, consulting, project management, and report writing services to healthcare clients • Work as part of an audit team to complete client projects within productivity, quality, and deadline standards • Access medical record documentation from client EMR systems • Analyze medical records for chart content, coding accuracy, and documentation requirements • Use audit reporting tools to document results and prepare reports for quality assurance review and client delivery • Interpret and apply CMS, AMA, OIG, NCCI, third-party payer, and other regulatory guidance • Identify documentation, coding, billing, reimbursement, and compliance risk trends • Communicate findings to clients and internal leadership • Develop audit findings, compliance recommendations, and corrective action plans • Prepare and present audit results, executive summaries, and compliance recommendations to providers, administrators, attorneys, and executive leadership • Conduct education and training sessions for team members, providers, and clients • Serve as a resource for providers on documentation, coding, and compliance matters • Participate in quality assurance and peer review activities • Assist with audit tools, educational materials, methodologies, and compliance resources • Coordinate research and resources for client engagements and special projects • Assist leadership with on-time, in-scope, and on-budget project delivery • Support project scope and objective development and stakeholder engagement • Develop and maintain client and stakeholder relationships • Review quality assurance audit reports and implement corrections and adjustments • Maintain current knowledge of healthcare auditing principles, regulatory compliance guidance, reimbursement methodologies, and payer requirements • Use Microsoft Office Suite and other audit-related technologies

🎯 Requirements

• High School Diploma required • Bachelor's degree preferred • Minimum of 3 years of healthcare auditing, documentation review, compliance, regulatory, or related healthcare experience • Experience conducting detailed medical record reviews and evaluating documentation requirements • Experience auditing professional coding across multiple specialties and service settings • Demonstrated experience with healthcare regulatory guidelines, including teaching physician settings, incident-to billing, split/shared services, and payer requirements • Experience analyzing payer policies, regulatory guidance, and reimbursement requirements and translating findings into actionable recommendations • Experience developing audit findings, corrective action plans, and compliance recommendations • Experience preparing written audit reports and presenting findings to providers, executives, compliance leadership, and other stakeholders • Experience delivering provider and staff education related to documentation, coding, and compliance requirements • Experience working independently in a consulting or client-service environment preferred • Advanced knowledge of physician documentation, E/M coding, compliance auditing methodologies, healthcare reimbursement principles, and regulatory requirements • Ability to evaluate complex documentation scenarios and apply nuanced regulatory guidance to support defensible audit conclusions • Strong written communication skills, including audit report writing, corrective action planning, and executive-level communications • Ability to communicate complex compliance and regulatory information clearly and confidently in both individual and group settings • Ability to effectively facilitate provider education and training • Ability to identify trends, interpret data, and develop practical, risk-based recommendations • Strong organizational, planning, project management, problem-solving, and decision-making skills • Ability to manage multiple priorities and projects in fast-paced environments while consistently meeting deadlines • Strong attention to detail in auditing, compliance reviews, and documentation analysis • Commitment to exceptional client service and relationship management • Demonstrated professionalism and executive presence when interacting with clients and stakeholders • Ability to foster teamwork and collaboration while maintaining a professional and positive attitude • Familiarity with AI-powered auditing and compliance tools • Advanced proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) and related technologies • Ability to work independently with minimal supervision while achieving high productivity and quality outcomes • Certified Professional Medical Auditor (CPMA) required • Certified Professional Coder (CPC) required • Certified in Healthcare Compliance (CHC) preferred • Certified Professional Compliance Officer (CPCO) preferred • Certified Risk Adjustment Coder (CRC) preferred • Registered Health Information Administrator (RHIA) preferred • Registered Health Information Technician (RHIT) preferred • Certified Outpatient Coder (COC) preferred • Other healthcare auditing or compliance-related certifications preferred

🏖️ Benefits

• Fully remote work arrangement • Full-time employment • Support from an industry-recognized team • Opportunity to build a career in healthcare compliance and auditing