Cardinal Health · 22 hours ago
Manager, Auditing and Monitoring
United States
Full-time
Remote
Senior Level, Lead/Staff
$106K/yr - $150K/yr
8+ years expCardinal Health is a healthcare solutions company dedicated to integrity and compliance. They are seeking a skilled Manager for Auditing and Monitoring to oversee compliance standards and manage billing audits in their At-Home Solutions business, ensuring adherence to healthcare regulations and fostering collaboration across teams.
Health CareHospitalMedical
Responsibilities
Provides compliance-related expertise and advice to Revenue Cycle management and other business teams with respect to day-to-day operations, including, without limitation, advice on Medicare and Medicaid DMEPOS supplier billing requirements, local coverage determination requirements, Medicare DMEPOS Supplier and Quality Standards, and other payor requirements
Serves as liaison with third party government contractors conducting audits as well as managing a small internal billing compliance team
Plans professional compliance department audits to determine accuracy and adequacy of documentation and coding related to DMEPOS supplies billing and/or medical necessity reviews and other high-risk areas as appropriate
Leads data analytics on audit outcomes; identifies and reviews audit trends and makes recommendations on remedial action to address such trends
Evaluates the appropriateness of items billed based on supporting record documentation and ensures documentation conforms to CMS and/or payor requirements
Prepares written reports of audit findings, with recommendations, and presents to appropriate stakeholders; evaluates the adequacy of management corrective action to improve deficiencies; maintains audit records
Collaborates with the Legal team to conduct risk assessments to define audit priorities based on previous audit findings, management priorities, national normative data, CMS initiatives, OIG work plans and advisories and healthcare industry best-practices
Develops and implements compliance training 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
Plans and conducts regular compliance training for Revenue Cycle team members, as needed
Provides feedback and training for staff regarding potential claim deficiencies
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
Supports the overall workplan of the Compliance Department
Interacts with subordinates, peers, customers and suppliers at various management levels and may interact with senior management
Interactions normally involve resolution of issues related to operations and/or projects
Gains consensus from various parties involved
Other duties as assigned
Qualification
Required
Familiarity with key laws, regulations, and sub-regulatory guidance that affects DMEPOS businesses and by federal and state government programs, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act, Civil Monetary Penalties Law, Stark, and Beneficiary Inducement Statutes); works collaboratively with the Legal Team to help advise the At-Home Solutions business
Expert-level knowledge of Medicare and Medicaid billing and documentation requirements; healthcare compliance audit methodology, principles and techniques; CMS Medicare manuals; DMEPOS reimbursement and repayment; confidentiality standards
Ability to interpret and apply coverage determination, documentation and coding rules, laws and regulations and to interpret medical record progress notes, handwritten and electronic chart entries, provider orders and other related documentation
Strong attention to detail with an emphasis on organizational and analytical skills
Understanding of institutional risks and appropriate judgment to use a risk-based approach in planning and executing duties
Ability to communicate complex and potentially sensitive issues to all levels of management including senior leadership
Prompt and efficient ability to manage shifting priorities, demands and timelines using analytical and problem-solving capabilities
Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment
Excellent problem-solving skills with self-starter qualities, enabling management of responsibilities to function effectively and efficiently
Strong communication and presentation skills
Proficiency in MS Word, Excel, PowerPoint, and Outlook
Manages department operations and supervises professional employees, front line supervisors and/or business support staff
Participates in the development of policies and procedures to achieve specific goals
Ensure employees operate within guidelines
Decisions have impact on work processes, and outcomes
Ability to work in a team environment with the ability to handle multiple audits at once
Knowledge of claim lifecycles and revenue cycle management
Knowledge of CMS Local Coverage Determination policies, and various payor requirements
Professional auditing experience
Exceptional Customer Service Skills
Proven interpersonal communication skills
Excellent time management, personal integrity and ability to maintain confidentiality
Preferred
8-12 years of experience, preferred
Bachelor's degree in related field, or equivalent work experience, preferred
7+ years of related work experience supporting compliance programs in DMEPOS suppliers, coding and medical necessity expertise, preferred
Related work experience with Brightree, preferred
Benefits
Medical, dental and vision coverage
Paid time off
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
2026-01-12
Fortune
2025-12-19
GlobeNewswire
2025-12-18
Company data provided by crunchbase