Medical Coding Compliance Auditor

Description

At VMG Health, we’re more than just a team of experts; we’re trusted partners in the business of healthcare. Backed by a team of over 300 professionals and a history of more than 70,000 engagements since 1995, we bring experience, deep and wide, to every project. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms.

Our solutions-oriented approach to client needs is bolstered by our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clients’ valuation, strategic, and compliance needs.

VMG Health is seeking an experienced Medical Coding Compliance Auditor to join its Coding Audit and Compliance (CAC) team. The Compliance Auditor will provide auditing, compliance, education, consulting, project management, and report writing services to a broad range of healthcare clients, including physician practices, hospitals, health systems, academic medical centers, law firms, private equity organizations, and other healthcare entities. This role is responsible for conducting documentation and coding reviews, regulatory research, due diligence support, provider education, compliance auditing, and developing corrective action recommendations.

The Compliance Auditor will serve as a trusted resource to clients and internal team members, providing subject matter expertise in coding, documentation, compliance, and regulatory requirements. Strong analytical, critical-thinking, communication, and client-service skills are essential to success in this role. This is an excellent opportunity for a professional seeking to build a career in healthcare compliance and auditing with the support of an industry-recognized team.

• Work as part of an audit team professionally and successfully complete client projects, meeting productivity and quality standards within established deadlines.
• Access necessary medical record documentation from client EMR systems.
• Complete detailed analysis of medical records for chart content, coding accuracy, and documentation requirements.
• Utilize audit reporting tools to document audit 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 to audit findings and compliance recommendations.
• Identify documentation, coding, billing, reimbursement, and compliance risk trends and communicate findings to clients and internal leadership.
• Develop reports of audit findings, compliance recommendations, and corrective action plans based on identified issues.
• Prepare and present audit results, executive summaries, and compliance recommendations to providers, administrators, attorneys, and executive leadership.
• Conduct education and training sessions for internal team members, providers, and clients.
• Educate and serve as a resource for providers regarding documentation, coding, and compliance matters.
• Participate in quality assurance and peer review activities to ensure consistency, accuracy, and defensibility of audit outcomes.
• Assist with the development and maintenance of audit tools, educational materials, methodologies, and compliance resources.
• Coordinate, research, and access resources necessary for the execution of client engagements and special projects.
• Assist leadership in ensuring projects are delivered on time, within scope, and within budget.
• Support the development and clarification of project scope and objectives while engaging relevant stakeholders and confirming project feasibility.
• Develop and maintain strong…