Compliance Billing & Coding Auditor II

Stanford Health Care

Healthcare compliance auditor reviewing billing, coding, documentation, and reimbursement accuracy for Stanford Health Care. Investigating discrepancies and recommending corrective actions to reduce compliance risks.

Posted 8/12/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $53 - $70 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting proactive and retrospective coding and billing audits, ensuring compliance with healthcare regulations and coding guidelines. Proficient in analyzing data for errors and providing actionable recommendations to improve billing processes and training materials.

Highest-signal resume keywords

CCS CertificationCPC CertificationICD-10-CM KnowledgeHealthcare Compliance Audit ExperienceEPIC EHR Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Coding AuditsBilling AuditsData AnalysisICD AssignmentsCPT AssignmentsRegulatory ComplianceHealthcare RegulationsAudit ReportingRisk AssessmentThird-Party Payer Rules

Soft Skills

Critical ThinkingProblem SolvingEffective CommunicationLeadershipOrganizational Skills

Tools & Technologies

EPIC3MMicrosoft WordMicrosoft ExcelMicrosoft PowerPoint

Certifications & Qualifications

CCS-P CertificationCIC CertificationCOC Certification

Industry Keywords

Healthcare ComplianceBilling and CodingAcademic Medical CenterFraud DetectionCompliance Training

About the role

Key responsibilities & impact

Initiate and perform proactive coding and billing audits before claims submission, and conduct retrospective audits when required
Use auditing software and tools to streamline audits and improve data analysis
Monitor and analyze billing and coding data for errors and regulatory non-compliance
Evaluate medical services and the accuracy of ICD, HCPCS, CPT, E&M, APC, DRG assignments, and charges
Review documentation supporting billed services and identify compliance risks through risk assessments
Conduct investigations and independent audits of facility and professional fee accounts for all patient types
Collaborate with relevant departments to gather information and evaluate documentation
Prepare audit and investigative reports with findings, corrective-action recommendations, and improvement areas
Monitor implementation and effectiveness of corrective actions
Provide feedback to Billing and Coding educators to improve training materials
Track federal, state, payer, healthcare regulations, and coding-guideline changes
Participate in compliance training and assist with developing training content for revenue cycle departments
Assist educators in responding to compliance inquiries
Contribute to the Office of Compliance and Privacy’s Risk Assessment, Workplan, and strategic goals

Requirements

What you’ll need

Associate’s degree in a work-related discipline/field from an accredited college or university, or equivalent combination of education/experience, required
Minimum four (4) years of progressively responsible directly related work experience required
CCS, CCS-P, CPC, CIC, or COC certification required within 180 days
EPIC EHR experience preferred
Knowledge of ICD-10-CM/PCS, HCPCS, E&M, CPT, DRG/APC reimbursement, and third-party payer rules
Knowledge of healthcare compliance audit requirements, principles, and techniques
Ability to plan, organize, and conduct detailed healthcare corporate compliance functions and audits
Ability to identify waste, fraud, abuse, and inefficiencies in conformance with laws, regulations, and standards
Ability to reach independent decisions, logical conclusions, and prepare reports of findings and recommendations
Knowledge of computer systems, specifically EPIC and 3M
Proficiency with Microsoft Word, Excel, and PowerPoint
Ability to manage priorities, multitask, adapt to changing priorities, communicate effectively, summarize data, and present results
Ability to provide leadership in problem identification and issue resolution
Ability to apply critical thinking, mediate, and solve complex work problems
Ability to facilitate work groups to successful outcomes
Ability to maintain confidentiality and current knowledge of healthcare compliance requirements, practices, and trends
Hospital and/or professional auditing experience in an Academic Medical Center preferred

Benefits

Comp & perks

Remote work arrangement
Full-time employment
Day shift, 08-hour schedule
Professional development through compliance training sessions and workshops
Participation in developing compliance training content
Equal opportunity employment