Senior Clinical Compliance Auditor

📋 Description

• Lead internal clinical audit programs and drive documentation quality, regulatory alignment, and
• Design and execute recurring audit plans: pre-bill and post-bill reviews, monthly sampling
• Review clinical docs for payer and regulatory compliance (treatment plans, session notes
• Analyze audit results, calculate error rates, identify trends, and recommend preventive actions.
• Maintain and update multi-state regulatory and payer requirement matrices.
• Manage audit tools/platforms, review AI-generated findings, improve reporting.

🎯 Requirements

• 3–5+ years in U.S. healthcare compliance, clinical auditing, medical coding, or documentation
• Experience supporting Medicaid and/or MCO audit responses including documentation prep and appeals.
• Strong knowledge of U.S. Medicaid documentation standards and medical necessity requirements.
• Excellent written English; ability to prepare audit summaries/reports.
• Experience tracking CPT codes, coding guidelines, and payer policy changes; convert updates into
• Proficiency with EHR systems, practice management, and audit/monitoring reporting tools.

🎁 Benefits

• Competitive compensation paid in USD.
• Fully remote work environment.
• Opportunity to work with an international and growing organization.
• High-impact role supporting healthcare quality and compliance improvements.
• Collaborative environment with opportunities for professional growth.