Compliance Auditor- Medical Claims
About the position Experienced Medical Compliance Auditor Compliance Auditor – Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and eager to make a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client’s dynamic team! This hybrid position offers the perfect blend of in-office collaboration and remote work, all while contributing to an organization committed to excellence in patient care and regulatory adherence. In this pivotal role, you’ll leverage your healthcare environment experience—whether as a Certified Professional Coder or similar professional—to audit and monitor clinical records, ensuring accuracy, completeness, and compliance. Your expertise with medical terminology, coding, and documentation will support our mission to uphold the highest standards of integrity and ethical practice. You’ll conduct anesthesia chart reviews, identify billing and coding discrepancies, and communicate findings effectively to practitioners and teams. Responsibilities • Support the Compliance Officer and the overall Compliance Program • Conduct anesthesia chart reviews to ensure records are complete, accurate, and support proper billing and coding • Audit anesthesia records focusing on quality, completeness, and correctness of claims based on services provided • Communicate review findings clearly and effectively to anesthesia practitioners and internal departments • Identify and address billing and coding gaps, including issues related to Time, Place of Service, Modifiers, CPT, and Diagnosis coding • Perform periodic probe audits to detect coding discrepancies that may lead to over- or under-billing • Document audit results and maintain reports; support educational efforts to improve compliance practices • Collaborate with internal departments and external auditors/consultants for billing and coding audits or consultations • Assist in addressing compliance concerns raised by staff through confidential mechanisms • Research documentation in ancillary systems to resolve overlapping times and billing issues • Support special requests for case logs, documentation, and records for anesthesia services as needed • Stay current on industry trends, regulatory updates, and best practices to ensure ongoing compliance • Serve as a backup to the Compliance Officer in their absence Requirements • healthcare environment experience • Certified Professional Coder or similar professional • expertise with medical terminology, coding, and documentation Apply tot his job