Compliance Coding Auditor, ATM

About the role

The Compliance Coding Auditor plays a crucial role within AMM's Compliance and Ethics team. Their responsibilities include supporting the Company's Compliance & Ethics Program by auditing, tracking, and monitoring initiatives. The role is expected to exemplify AMM's culture and core values, demonstrating sound judgment, productive collaboration, and success in auditing billing and risk adjustment metrics.

Responsibilities

• Ensures timely communication of key audit findings to the Manager.
• Remains informed of healthcare compliance trends through professional development and participation in relevant organizations.
• Performs internal audits to assess the accuracy and adequacy of documentation and coding related to physician billed services.
• Prepares and presents written reports of audit findings to the Manager for review.
• Develops and implements corrective action plans for identified systemic issues or pervasive practices.
• Collaborates with business unit leaders to address compliance and ethics concerns.

Requirements

• Five to ten years of relevant professional experience in healthcare, including coding and/or auditing roles.
• Experience auditing healthcare claims in a professional services firm and/or in-house at a large healthcare provider organization, health system, and/or payer.
• An undergraduate degree in Health Business or a related field, or equivalent combination of education and experience.
• Coding certification, preferred Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) from the American Academy of Professional Coders (AAPC).
• Auditing certification, preferred Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders (AAPC).
• Understanding of government healthcare programs (Medicare and Medicaid).
• Demonstrated ability to work effectively with key internal and external stakeholders.

Qualifications

• Exemplary integrity with a strong ethical compass.
• Pragmatic, risk-aware professional judgment.
• Tact, trustworthiness, and diplomacy skills for handling sensitive information.
• Effective listening and humility.
• Professional excellence and expertise.
• Prompt and efficient task management.

Skills

• Coding and auditing expertise.
• Communication and collaboration skills.
• Healthcare compliance knowledge.
• Leadership and problem-solving abilities.

Benefits

Join AMM and benefit from a comprehensive benefits package designed to support your health, wellness, and career growth:

• Employer-paid health coverage options.
• Discounted vision and dental premiums.
• Flexible spending accounts (FSAs) for managing healthcare and dependent care costs.
• 401(k) retirement savings plan.
• Generous paid time off (PTO) and holidays.
• Tuition reimbursement for educational advancement.
• Team-building events and lunches.