Compliance and Audit Specialist
Curai Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $90,000 - $120,000 per year
About the role
- Monitor and interpret changes in healthcare laws, regulations, and guidance from agencies such as CMS, OIG, OCR, and state health departments, assessing the impact on virtual care operations
- Conduct periodic risk assessments to identify compliance vulnerabilities and recommend corrective actions
- Plan and conduct internal compliance audits of clinical documentation, billing and coding practices, referral arrangements, and operational workflows in outpatient and clinic settings
- Analyze audit findings, prepare detailed reports with root-cause analyses, and track corrective action plans through resolution
- Draft, review, and update compliance policies, procedures, and standard operating procedures to reflect current regulatory requirements and industry best practices
- Develop and deliver compliance training content tailored to outpatient and clinic staff, including topics such as HIPAA/privacy, fraud and abuse, proper documentation, and code of conduct expectations
Requirements
- Bachelor's degree in Healthcare Administration, Health Information Management, Nursing, Business Administration, Public Health, or a related field
- Minimum of 3–5 years of progressive experience in healthcare compliance, regulatory affairs, coding/billing auditing, or a closely related function
- Certifications (one or more required, or must be obtained within 12 months of hire): Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified Professional Compliance Officer (CPCO), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) credentials are a plus
- Strong understanding of healthcare regulatory frameworks, including federal and state fraud and abuse laws, HIPAA, EMTALA, and CMS Conditions of Participation/Coverage
- Working knowledge of Medicare and Medicaid billing regulations, CPT/ICD-10 coding, and payer requirements applicable to outpatient services
Benefits
- comprehensive medical/dental/vision coverage
- 401k employer match
- annual CME reimbursement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
healthcare complianceregulatory affairscoding auditingbilling auditingrisk assessmentscompliance auditsCPT codingICD-10 codingMedicare billing regulationsMedicaid billing regulations
Soft Skills
analytical skillscommunication skillstraining developmentproblem-solvingattention to detailorganizational skillsreport writinginterpersonal skillsroot-cause analysispolicy drafting
Certifications
Certified in Healthcare Compliance (CHC)Certified in Healthcare Privacy Compliance (CHPC)Certified Professional Compliance Officer (CPCO)Certified Coding Specialist (CCS)Certified Professional Coder (CPC)