OCLI Vision · 16 hours ago
Manager Compliance Audit
Garden City, NY
Full-time
Onsite
Senior Level, Lead/Staff
$75K/yr - $95K/yr
10+ years expOCLI Vision is one of the largest multi-specialty ophthalmology networks in the U.S., partnering with Spectrum Vision Partners to deliver world-class eye care. The Manager, Compliance Audit is responsible for overseeing billing and coding compliance, ensuring adherence to regulations through audits, monitoring, and education.
Health CareHospitalMedical
Responsibilities
Lead prospective and retrospective billing and documentation compliance audits across clinical operations
Design audit methodologies, tools, sampling techniques, and risk-based monitoring programs
Analyze physician coding patterns, documentation practices, denials, and reimbursement trends
Identify compliance risks related to CPT, ICD-10-CM, HCPCS, and modifier usage
Prepare formal audit reports, compliance investigation summaries, and executive-level metrics
Develop, implement, and monitor corrective action plans; evaluate effectiveness and sustainability
Perform ongoing compliance monitoring related to OMIG, CMS, OIG, payer requirements, and sanction/exclusion screening
Support annual compliance risk assessments and compliance work plans related to coding, billing, and documentation
Develop and maintain compliance policies, workflows, and education materials
Deliver provider and staff education on regulatory guidance, documentation standards, and audit findings
Serve as a subject matter expert and front-line compliance resource for clinics and revenue cycle teams
Maintain current knowledge of regulatory updates, advisory opinions, and enforcement trends
Qualification
Required
Bachelor's degree or 10+ years of related experience
5+ years medical coding experience & 3+ years auditing experience
2+ years in a compliance department
2+ years managing staff
Strong Microsoft Office and project management skills
Knowledge of Fraud, Waste & Abuse laws
Skilled in auditing, education feedback, and regulatory documentation
Analytical, detail-oriented, trustworthy team player
CPC certification required
Preferred
Healthcare compliance/privacy certifications
Company
OCLI Vision
Spectrum Vision Partners (“SVP”) and OCLI Vision (“OCLI”) work together to provide world class eye care to our patients to improve lives.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Dr Gerard D'Aversa
OCLI Partner & Cornea, Cataract and Refractive Surgeon
Paul Krawitz
Ophthalmic Surgeon at OCLI/Spectrum Vision Partners
Recent News
2025-11-03
2025-11-03
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