Compliance Auditor - Professional Services
Location: Remote - FL
Department: Coding
Work Type: Full Time
Shift: Shift 1/ to
Minimum to Midpoint Pay Rate: $57,346 - $74,547 / Annual
Summary
Lee Health is seeking a Compliance Auditor – Professional Services to support coding compliance, documentation integrity, and revenue accuracy across Lee Physician Group. This role plays a critical part in ensuring adherence to federal and state regulatory requirements while promoting best practices in professional coding and clinical documentation.
The Compliance Auditor conducts risk-based audits of professional services coding and documentation, identifies areas of compliance risk, and collaborates with Coding Leadership, Compliance, Coding Education, and Production Coding teams to strengthen documentation practices and reduce denials. The position serves as a subject matter expert in professional coding compliance, providing actionable insights and education to support physicians, advanced practice providers, and coding teams.
This position requires deep expertise in ICD-10-CM, CPT, HCPCS, and Evaluation & Management (E/M) guidelines, as well as the ability to interpret complex regulatory guidance from organizations such as CMS, AMA, OIG, and other governing bodies. The ideal candidate is highly analytical, detail-oriented, and skilled at translating complex coding and compliance concepts into clear, actionable recommendations.
What You’ll Do
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Perform comprehensive risk-based audits of professional services coding and documentation to assess compliance with regulatory and organizational standards.
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Analyze audit findings and provide clear feedback and recommendations to Coding Leadership and Compliance partners.
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Research historical, concurrent, and emerging audit focus areas, including those identified by the OIG and internal compliance initiatives.
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Track and maintain detailed records of audit activities, findings, and outcomes to support compliance reporting and improvement initiatives.
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Identify documentation deficiencies and coding trends and collaborate with Coding Education and Production Coding teams to address them.
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Support denial prevention efforts by identifying documentation and coding improvement opportunities.
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Partner with Medical Informatics and Technical Education teams to improve documentation workflows, including templates, smart phrases, and procedure documentation standards.
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Serve as a coding compliance subject matter expert, providing guidance on regulatory requirements and coding guidelines.
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Assist Coding Leadership in proactively identifying and auditing areas of potential compliance risk.
Perform comprehensive risk-based audits of professional services coding and documentation to assess compliance with regulatory and organizational standards.
Analyze audit findings and provide clear feedback and recommendations to Coding Leadership and Compliance partners.
Research historical, concurrent, and emerging audit focus areas, including those identified by the OIG and internal compliance initiatives.
Track and maintain detailed records of audit activities, findings, and outcomes to support compliance reporting and improvement initiatives.
Identify documentation deficiencies and coding trends and collaborate with Coding Education and Production Coding teams to address them.
Support denial prevention efforts by identifying documentation and coding improvement opportunities.
Partner with Medical Informatics and Technical Education teams to improve documentation workflows, including templates, smart phrases, and procedure documentation standards.
Serve as a coding compliance subject matter expert, providing guidance on regulatory requirements and coding guidelines.
Assist Coding Leadership in proactively identifying and auditing areas of potential compliance risk.
Required Qualifications
Education
Bachelor’s degree in Healthcare, Business, or related field preferred
Experience
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Minimum 3 years of professional coding experience required
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Extensive knowledge of CPT, HCPCS, ICD-10-CM, outpatient coding, and E/M documentation guidelines
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Experience interpreting and applying federal healthcare regulations and coding standards
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Prior coding education or audit experience preferred
Minimum 3 years of professional coding experience required
Extensive knowledge of CPT, HCPCS, ICD-10-CM, outpatient coding, and E/M documentation guidelines
Experience interpreting and applying federal healthcare regulations and coding standards
Prior coding education or audit experience preferred
Certifications
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CPC – Certified Professional Coder (required)
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CPMA – Certified Professional Medical Auditor (required)
CPC – Certified Professional Coder (required)
CPMA – Certified Professional Medical Auditor (required)
Key Skills
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Strong analytical and critical thinking abilities
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Excellent written and verbal communication skills, including the ability to educate providers and leadership on technical coding concepts
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Ability to research, interpret, and apply complex regulatory guidelines
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Strong collaboration skills with cross-functional stakeholders
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Highly organized, detail-oriented, and self-motivated
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Ability to manage multiple priorities in a fast-paced healthcare environment
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Demonstrated ability to translate federal and state regulatory guidance into practical documentation and coding education
Strong analytical and critical thinking abilities
Excellent written and verbal communication skills, including the ability to educate providers and leadership on technical coding concepts
Ability to research, interpret, and apply complex regulatory guidelines
Strong collaboration skills with cross-functional stakeholders
Highly organized, detail-oriented, and self-motivated
Ability to manage multiple priorities in a fast-paced healthcare environment
Demonstrated ability to translate federal and state regulatory guidance into practical documentation and coding education
Why Join Lee Health
Lee Health is one of the largest public health systems in Florida and is committed to delivering exceptional care to our communities. As part of our Coding and Compliance team, you will play an important role in maintaining the integrity of our clinical documentation and coding practices while helping providers deliver accurate, compliant care.
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