Internal Auditor III

About the Role

Leads inpatient coding, billing compliance, and revenue integrity audits to evaluate regulatory compliance, identify risks, and improve operational effectiveness. Provides subject matter expertise and guidance to coding, CDI, revenue cycle, and operational teams while managing audits from planning through reporting in alignment with Sutter Health values and professional auditing standards.

Responsibilities

• Lead inpatient coding, billing compliance, and revenue integrity audits.
• Participate in annual risk assessments and audit plan development.
• Manage audit engagements, including scope, timelines, budgets, and reporting.
• Supervise and develop audit staff.
• Provide guidance to coding, CDI, compliance, and revenue cycle teams.
• Evaluate coding with regulatory, payer, and organizational requirements.
• Identify coding, documentation, and reimbursement risks and recommend improvements.
• Prepare audit reports and communicate results to leadership and stakeholders.
• Support continuous improvement of audit methodologies, workflows, and tools.

Requirements

• Extensive knowledge of hospital rules, regulations, coding and billing compliance requirements, NCDs, LCDs, and reimbursement methodologies.
• Advanced expertise in ICD-10-CM/PCS, CPT, and HCPCS coding systems.
• Ability to interpret regulatory guidance and provide accurate recommendations to operational, clinical, and revenue cycle teams.
• Certified Coding Specialist (CCS) certification (required).
• RHIA, RHIT, CDIP, and/or CCDS credential (preferred).
• Bachelor's Degree or equivalent experience.
• 5 years of recent relevant experience.

Skills

• Firm understanding of audit theory, processes, and professional practice standards of internal auditing, as well as core control frameworks.
• Advanced analytical and project management skills, including the ability to analyze data, reach practical conclusions, recommend corrective actions, resolve conflicts, and institute effective changes.
• Ability to work independently and as part of a multidisciplinary team with excellent organization skills.
• Manage multiple priorities/projects simultaneously, sometimes with rapidly changing priorities.
• Maintain audit/project schedules and meet tight and often conflicting deadlines.
• Analyze possible solutions using precedents, existing guidelines, and good judgment to solve standard problems.
• Maintain strict confidentiality and ensure the privacy of each patient’s protected health information (PHI).
• Build collaborative relationships with peers, other departments, stakeholders, and external agencies.
• Display a high degree of professionalism and leadership.
• Excellent verbal and written communication, interpersonal, and presentation skills with the ability to explain complex technical or sensitive information clearly and professionally to diverse audiences.

Benefits

Eligible positions include a comprehensive benefits package.

Pay

Pay range varies by geographic location:

• Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Virginia: $105,705.60 to $158,558.40 annual salary.
• Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, South Carolina, Tennessee, Utah: $93,953.60 to $140,940.80 annual salary.
• California, New Jersey, Washington: $117,436.80 to $176,155.20 annual salary.
• Other locations: $117,436.80 to $176,155.20 annual salary.

Total compensation considers multiple factors, including experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is one component of Sutter Health’s comprehensive total rewards program.

Schedule

• Full-time (40 hours per week).
• Day shift (Monday - Friday).
• No weekend requirements.