Senior Compliance Coding Auditor

You MatterMake a difference every day in the lives of the underservedJoin a mission driven organization with a people first cultureExcellent career growth opportunitiesJoin us and find a career that supportsCaring for overlooked, underserved, and vulnerable patientsDiversity, equity, inclusion, and belongingAutonomy in a warm team environmentGrowth and trainingPerks and BenefitsIn addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:DailyPay, receive your money as you earn it!Tuition Assistance and dependent ScholarshipsEmployee Assistance Program (EAP) including free counseling and health coachingCompany paid life insuranceTax free Health Spending Accounts (HSA)Wellness program featuring fitness memberships and product discountsPreferred banking partnership and discounted rates for home and auto loansEligibility for perks and benefits varies based on employee type and length of service.Why UsIf there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to "Always Do The Right Thing!", and to collectively do our part to heal the world, one patient at a time.Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan.We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.How you make a differenceThe Sr Compliance Coding Auditor performs complex coding audits across a range of services, including those delivered in correctional settings and through third-party billing vendors. This role serves as a subject matter expert on coding and documentation guidelines, identifying risks and preparing detailed audit findings. The position works closely with leadership to develop corrective actions and deliver education to providers and coders. This role also supports regulatory audits and provides guidance and mentorship to compliance staff.Key ResponsibilitiesPlan and conduct complex coding audits using risk-based sampling and established methodologies.Review provider documentation, coding, and modifier usage to ensure compliance with coding standards and payer rules.Analyze findings, prepare detailed audit reports, and present results to providers, coders, and leadership.Support corrective action planning, education efforts, and monitoring of compliance trends and regulatory updates.Provide guidance to compliance staff and support external audits, vendor oversight, and regulatory inquiries.Additional DetailsCertified Professional Medical Auditor, California (CA) CalAIM experience/knowledge highly preferred$70,000 - $96,000 per yearQualifications & RequirementsEducationBachelor's degree in Health Information Management, Healthcare Administration, or a related field preferredAssociate's degree with substantial equivalent professional coding and auditing credentials and experience may be consideredCompletion of formal coding and/or auditing training program (AAPC, AHIMA, or equivalent) requiredExperienceMinimum five (5) years of progressively responsible experience in professional coding and coding auditDemonstrated experience performing complex E/M, primary care, chronic disease management, behavioral health, and/or medication-assisted treatment (MAT) audits using AMA CPT, ICD-10-CM, HCPCS, and CMS guidanceExperience preparing detailed audit findings reports and presenting results to providers, coders, and operational leadershipWorking knowledge of OIG, CMS, AMA, and payer-specific compliance and documentation requirementsExperience auditing or overseeing third-party billing vendors strongly preferredFamiliarity with state Medicaid coding rules, Section 1115 Reentry Demonstration billing requirements, and correctional health workflows strongly preferredPrevious correctional/detention facility coding or auditing experience preferredLicenses/CertificationsCertified Professional Medical Auditor (CPMA) through AAPC - required, and/orCertified Professional Coder (CPC) - required, with Certified E/M Coder (CEMC) or Certified Professional Compliance Officer (CPCO) credential strongly preferredCertified Professional Biller (CPB) through AAPC - preferred, given the role's emphasis on third-party billing vendor oversight and government-program payer requirementsCertified Coding Specialist (CCS) through AHIMA may be substituted for an AAPC equivalentWe are an Equal Employment Opportunity EmployerWe are committed to fostering, cultivating, and preserving a culture of uniqueness.We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.We encourage you to apply! If you are excited about a role but your experience doesn't seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description.We are an affirmative action employer in accordance with applicable state and local laws.#J-18808-Ljbffr