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Providence Health & Services

Compliance Auditor -Remote

Posted 23 Days Ago
In-Office or Remote
7 Locations
29K-69K Hourly
Senior level
In-Office or Remote
7 Locations
29K-69K Hourly
Senior level
Conduct remote revenue cycle compliance audits across clinical and billing systems (Epic/EMR). Review charges, revenue codes, CPTs, documentation, and reimbursement accuracy. Collaborate with case management, revenue integrity, legal, and finance to present findings, reduce risk, and ensure regulatory compliance. Process overpayments per CMS self-disclosure rules.
The summary above was generated by AI

Providence is calling for Compliance Auditor - Remote

The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures.

Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle:

  • Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT.

This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team,  Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager.

The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing line-item charges, Revenue Codes, CPT descriptions, status, orders, supporting documentation, and reimbursement etc. The auditor applies strong critical thinking and analytical skills to evaluate accuracy, identify discrepancies, and ensure compliance while completing focused audits.

Audit findings are presented in a collaborative manner (verbally and visually) looking to a common goal of reducing risk within Providence as a system.

Overpayments received in error are refunded following the CMS Voluntary Self Disclosure 60 Day Overpayment Rule.

This position works remotely and is open to candidates residing in:

  • Alaska
  • Washington
  • Montana
  • Oregon
  • California
  • Texas
  • New Mexico

Providence caregivers are not simply valued – they’re invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. 
Required Qualifications:

  • Bachelor's Degree in Business, Healthcare, Finance, or similar field, Or 5 years of recent Hospital Billing auditing, Nurse Auditing, or Hospital billing and coding experience. 
  • 5 years of recent Hospital billing auditing or  Hospital coding experience.

Preferred Qualifications:

  • Upon hire: Coding Certification from American Health Information Management Association 

Salary Range by Location:

AK: Anchorage: Min: $37.84, Max: $58.75

AK: Kodiak, Seward, Valdez: Min: $39.45, Max: $61.24

California: Humboldt: Min: $39.45, Max: $61.24

California: All Northern California - Except Humboldt: Min: $44.26, Max: $68.71

California: All Southern California - Except Bakersfield: Min: $39.45, Max: $61.24

California: Bakersfield: Min: $37.84, Max: $58.75

Montana: Except Great Falls: Min: $30.47, Max: $47.30

Montana: Great Falls: Min: $28.86, Max: $44.81

New Mexico: Min: $30.47, Max: $47.30

Oregon: Non-Portland Service Area: Min: $35.28, Max: $54.77

Oregon: Portland Service Area: Min: $37.84, Max: $58.75

Texas: Min: $28.86, Max: $44.81

Washington: Western: Min: $39.45, Max: $61.24

Washington: Southwest - Olympia, Centralia & Below: Min: $37.84, Max: $58.75

Washington: Eastern: Min: $33.67, Max: $52.28

Washington: South Eastern: Min: $35.28, Max: $54.77


Why Join Providence?  

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. 

About Us
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position.  The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
About the TeamProvidence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

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