The role provides strategic leadership for the organization's professional compliance audit program with a strong emphasis on Evaluation & Management services
Job Summary
The role provides strategic leadership for the organization's professional compliance audit program with a strong emphasis on Evaluation & Management services.
The manager leads a team of auditors to deliver high-quality internal reviews and implement corrective actions to reduce risk.
This position requires expert knowledge of CMS rules, ICD-10-CM, CPT, and HCPCS coding standards to ensure regulatory compliance.
Matching Summary
The role provides strategic leadership for the organization's professional compliance audit program with a strong emphasis on Evaluation & Management services.
Skills & Requirements
Must-have
8+ years professional coding experience
Expert knowledge of E/M guidelines
Proficiency with Epic EMR systems
Risk-based internal audit execution
CMS and federal payer policy expertise
Nice-to-have
Experience mentoring compliance teams
Strong analytical and communication skills
Ability to drive cross-functional collaboration
Proven track record in revenue assurance
Key Requirements
Bachelor's degree required
Certified Coding Specialist (CCS) or CPMA certification
8 or more years of relevant experience
RHIT or RHIA certification accepted as alternative