Compliance Auditor -Remote Job Wisconsin USA,Healthcare

Overview

Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations.

The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement.

Audit findings are presented verbally and visually to reduce risk within the Providence system. Over payments received in error are refunded following the CMS Voluntary Self Disclosure 60 Day Overpayment Rule.

Remote Eligibility

Alaska
Washington
Montana
Oregon
California
Texas
New Mexico

Responsibilities

Conduct audits to evaluate compliance with federal, state, and Providence policies and procedures.

Analyze clinical EMR and Epic billing data for line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement.

Identify discrepancies and ensure compliance through critical thinking and analytical skills.

Present audit findings verbally and visually to stakeholders.

Refund over payments in accordance with CMS rules.

Collaborate with internal departments such as Case Management, Utilization Review, Revenue Integrity, Clinical Risk, Internal Legal Affairs, and Finance.

Required Qualifications

Bachelor's Degree in Business, Healthcare, Finance, or a similar field.
At least 5 years of recent hospital billing auditing or hospital coding experience.

Preferred Qualifications

Coding certification from the American Health Information Management Association (upon hire).

Salary Range by Location

AK:
Anchorage – Min: $37.84, Max: $58.75

AK:
Kodiak, Seward, Valdez – Min: $39.45, Max: $61.24

California:
Humboldt – Min: $39.45, Max: $61.24

California:
All Northern California – Except Humboldt – Min: $44.26, Max: $68.71

California:
All Southern California – Except Bakersfield – Min: $39.45, Max: $61.24

California:
Bakersfield – Min: $37.84, Max: $58.75

Montana:
Except Great Falls – Min: $30.47, Max: $47.30

Montana:
Great Falls – Min: $28.86, Max: $44.81

New Mexico – Min: $30.47, Max: $47.30

Oregon:
Non-Portland Service Area – Min: $35.28, Max: $54.77

Oregon:
Portland Service Area – Min: $37.84, Max: $58.75

Texas – Min: $28.86, Max: $44.81

Washington:
Western – Min: $39.45, Max: $61.24

Washington:
Southwest – Olympia, Centralia & Below – Min: $37.84, Max: $58.75

Washington:
Eastern – Min: $33.67, Max: $52.28

Washington:
South Eastern – Min: $35.28, Max: $54.77

Benefits

Competitive salary with possible shift differentials, standby/on-call, overtime, premiums, extra shift incentives, and bonus opportunities.
Retirement 401(k) savings plan with employer matching.
Health care benefits: medical, dental, and vision.
Life insurance, disability insurance, and voluntary benefits.
Paid parental leave, vacations, holidays, and health‑issue time off.
Well‑being resources.

Equal Opportunity Employer

Providence is an equal opportunity employer. We are committed to a workplace free from unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger and dedicate ourselves to shaping an inclusive workforce.

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