Cardinal Health · 18 hours ago
Compliance Audit Manager
United States
Full-time
Remote
Senior Level
$105K/yr - $140K/yr
6+ years expCardinal Health is a healthcare services and products company that promotes ethical conduct and compliance. The Compliance Audit Manager will supervise and manage compliance audits related to billing for professional and hospital services, support the Director with audit diligence, and develop the annual risk assessment and audit plan.
Health CareHospitalMedical
Responsibilities
Plans professional compliance department audits to determine accuracy and adequacy of documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews
Prepares written reports of audit findings and recommendations; presents to appropriate stakeholders; evaluates the adequacy of management corrective action to improve deficiencies; maintains audit records
Conducts risk assessments to define audit priorities based on previous audit findings, management priorities, coding utilization patterns, national normative data, CMS and CCI initiatives, OIG work plans and advisories as well as healthcare industry best-practices
Develops and implements compliance training and education to ensure compliance with federal and state regulations and laws, CMS and other third-party payer billing rules and internal documentation, coding and billing policies and procedures
Provides feedback and training for physicians and staff regarding coding insufficiencies
Serves as institutional subject matter expert and authoritative resource regarding federal, state and payer documentation, billing and coding rules and regulations, maintaining awareness of governmental regulations, protocols and third-party requirements
Serves as liaison with 3rd party auditors conducting audits as well as manages in-house auditing staff
Supports the overall workplan of the Compliance Department
Qualification
Required
Bachelor's degree in Health Information Management, Business or related field preferred
6+ years of experience in physician and/or hospital coding and auditing, medical necessity reviews, or related work; cancer and urology service line experience preferred; ASTRO and ACR-guideline knowledge a plus
AAPC, AHIMA or HCCA Coding certification and or Auditing/Compliance certification (CPC, CCS, CCS-P, COC, CPMA, CHC) preferred
Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; recommends opportunities to strengthen the internal control structure
Understands institutional risks and shows appropriate judgment, using a risk-based approach in planning and executing audit plans
Expert-level knowledge and application of Medicare/Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCS/DRG/APC documentation coding rules; medical terminology; E/M rules; healthcare compliance audit methodology, principles and techniques; ability to interpret medical record progress notes, handwritten and electronic chart entries, provider orders and other related documentation during audit reviews
Ability to communicate complex and potentially sensitive issues to all levels of management, physicians, and others; strong presentation and communication skills (MS Word, Excel, PowerPoint, and Outlook)
Manages department operations and supervises professional employees, front line supervisors and/or business support staff
Applies advanced knowledge and understanding of concepts, principles, and technical capabilities to manage a wide variety of projects
Participates in the development of policies and procedures to achieve specific goals
Recommends new practices, processes, metrics, or models for a successful auditing program
Possesses strong attention to detail
Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment
Independently determines method for completion of new projects
Receives guidance on overall project objectives
Excellent time management, personal integrity and ability to maintain confidentiality
Preferred
Bachelor's degree in Health Information Management, Business or related field
6+ years of experience in physician and/or hospital coding and auditing, medical necessity reviews, or related work; cancer and urology service line experience
AAPC, AHIMA or HCCA Coding certification and or Auditing/Compliance certification (CPC, CCS, CCS-P, COC, CPMA, CHC)
Benefits
Medical, dental and vision coverage
Paid time off plan
Health savings account (HSA)
401k savings plan
Access to wages before pay day with myFlexPay
Flexible spending accounts (FSAs)
Short- and long-term disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs
Company
Cardinal Health
Cardinal Health is a manufacturer and distributor of medical and laboratory products.
10001+ employees
H1B Sponsorship
Cardinal Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (128)
2024 (116)
2023 (140)
2022 (158)
2021 (106)
2020 (142)
Funding
Current Stage
Public CompanyTotal Funding
$1.08B2025-08-28Post Ipo Debt· $1B
2006-08-16Post Ipo Debt· $78M
1983-08-12IPO
Leadership Team
Aaron Alt
Chief Financial Officer
T
Tony Caprio
Executive Vice President
Recent News
Fortune
2025-12-19
GlobeNewswire
2025-12-18
vcnewsdaily.com
2025-12-17
Company data provided by crunchbase