Compliance Analyst Risk & Auditing experience

Job Description

Job Description

Compliance Analyst – Risk & Audit

Location: Greater Silicon Valley, CA
Work Arrangement: Hybrid
Employment Type: Full-Time | Exempt
Salary: $104,000 to $124,800

Turn Risk into Action

Cornerstone Staffing Solutions is seeking a detail-driven Compliance Analyst with strong experience in healthcare risk, auditing, investigations, and regulatory compliance. This position will evaluate organizational exposure, identify control weaknesses, support internal and external audits, and help leadership reduce regulatory, operational, and financial risk.

What You’ll Do

Risk Assessment and Mitigation

• Conduct compliance risk assessments across clinical, billing, coding, and operational functions.
• Identify control gaps, emerging risks, and areas of regulatory exposure.
• Analyze denials, documentation errors, coding accuracy, and other risk indicators.
• Recommend practical controls and risk-mitigation strategies.
• Monitor corrective action plans through resolution.

Auditing and Investigations

• Support and conduct internal compliance audits and targeted reviews.
• Coordinate documentation for external audits, payer inquiries, and regulatory requests.
• Prepare audit summaries, findings reports, and defensible response materials.
• Investigate billing irregularities and suspected fraud, waste, or abuse.
• Perform root-cause analysis and recommend corrective actions.
• Track audit findings, remediation efforts, and ongoing control effectiveness.

Regulatory Compliance

• Monitor requirements and guidance from CMS, OIG, AMA CPT, and commercial payers.
• Evaluate how regulatory changes affect workflows, billing, documentation, and internal controls.
• Translate complex requirements into clear operational guidance.
• Support compliance involving Stark Law, Anti-Kickback Statute, conflicts of interest, and professional-fee billing.

Reporting and Program Support

• Create risk dashboards, audit reports, and compliance performance metrics.
• Present trends, findings, and recommendations to compliance and operational leadership.
• Maintain organized records of audits, investigations, and corrective actions.
• Assist with compliance policies, procedures, education, and staff training.
• Partner with providers, coders, practice managers, legal counsel, and revenue cycle teams.

What We’re Looking For

• High school diploma or equivalent required
• Bachelor’s degree in healthcare administration, business, or a related field preferred
• CHC, CHPC, CPC, or COC certification—or ability to obtain one within six to nine months
• Healthcare compliance, auditing, or operational risk experience
• Experience investigating potential fraud, waste, abuse, or billing irregularities
• Knowledge of professional coding, billing, documentation, and payer requirements
• Strong ability to interpret clinical documentation and billing data
• Proficiency with Excel, business intelligence tools, or compliance audit software
• Excellent written communication, reporting, and analytical skills
• Ability to explain complex audit findings and regulatory requirements clearly

Why This Role Matters

Your work will help the organization identify risk before it becomes an issue, respond confidently to audits, strengthen internal controls, and maintain defensible compliance practices across the medical network.

Ready to Strengthen Healthcare Compliance?

Bring your auditing experience, analytical judgment, and risk-focused mindset to a role where your findings will influence meaningful operational decisions. Apply today through Cornerstone Staffing Solutions.