Yale University · 1 day ago
Compliance Auditor
United States
Full-time
Remote
Mid, Senior Level
$68K/yr - $120K/yr
5+ years expYale University is a prestigious institution dedicated to contributing to a better tomorrow. They are seeking a Compliance Auditor to coordinate and conduct medical billing audits, evaluate compliance, and provide training and feedback to staff involved in billing activities.
AssociationBusiness DevelopmentEducationMedicalSocial Entrepreneurship
Responsibilities
Primary responsibility is to complete audits of departmental compliance chart reviews and to participate in audits requested by third party payors
Assess provider documentation for IDC-10 and CPT-4 coding accuracy, compliance with University and government regulations
Obtain and review charge documents, encounter forms, medical records and billing procedures
Evaluate results, identify system control weaknesses and in conjunction with department management, develop plan of action and solutions based on audit results
Participate in the implementation of corrective action changes
Design and maintain accurate tracking logs, including spreadsheets, of all ongoing investigations
Follow up on corrective action. Report findings to the Compliance Officer, PFS and University Auditor as needed
Conduct training sessions with individual physicians and/or departments on medical billing compliance. Provide input on areas and subjects where education is needed
Advise and assist in development of training materials and programs for clinical and billing staff relative to accurate coding, documentation billing and regulatory guidelines
Conduct data analysis. Generate reports using Query tools to identify trends and problem areas for focus of internal audits
Participate in the ongoing implementation of the Compliance Program. Knowledge of University Medical Billing Compliance Plan, operations and procedures
Stay abreast of best practice coding and auditing practices and regulatory changes. Maintain CPC designation by obtaining necessary CEUs on an annual basis
Qualification
Required
Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices
Ability to interpret operative and procedural reports
Well-developed oral and written communication skills
Strong attention to detail with the ability to analyze data
Proficient in Microsoft Word, Excel, and Access
CPC or similar certification needed within 12-18 months
Bachelor's in Health Care Management, Finance, Business or Nursing or a related field
Five years' experience in multi-specialty group practice, academic plan or hospital or an equivalent combination of educational and experience
Preferred
CPC credentials preferred
Computer skills including Epic, WEBI, Word, Excel, and Access
Proven experience in healthcare auditing, Medicare and Medicaid, or related clinical field
Proven experience in healthcare auditing, Medicare and Medicaid, or related clinical experience
Company
Yale University
Yale University is a research and education institution that prioritizes its students.
10001+ employees
H1B Sponsorship
Yale University 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 (355)
2024 (449)
2023 (214)
2022 (208)
2021 (190)
2020 (155)
Funding
Current Stage
Late StageTotal Funding
$42.86MKey Investors
Bezos Earth FundAlfred P. Sloan FoundationHyundai Hope On Wheels
2025-10-23Grant
2025-05-21Grant· $0.05M
2023-01-01Grant· $1.27M
Leadership Team
Geoffrey Chatas
Senior Vice President for Operations
Jack Callahan
Senior Vice President for Operations
Recent News
2025-12-10
Company data provided by crunchbase