CODING COMPLIANCE AUDITOR (Remote)

Country-wide Remote
US-Nationwide-FIELD
Full time
What Ethics & Compliance contributes to Cardinal Health
Ethics & Compliance promotes a culture that encourages ethical conduct and a commitment to compliance. This function implements strategies and processes to ensure adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues.
Ethics & Compliance develops and implements strategies and standard operating procedures to promote adherence to internal ethics and compliance policies related to areas such as privacy, HIPAA and FCPA, among others. This job family resolves concerns from business unit leaders and employees and proactively provides guidance and trainings on policies.
The Compliance Auditor is responsible for conducting coding, documentation audits to ensure adherence to regulatory requirements, payer policies, and organizational standards. This position focuses primarily on Medical Oncology, Radiation Oncology and Urology services and requires advanced knowledge of CPT, HCPCS, ICD-10-CM, reimbursement methodologies, and healthcare compliance regulations.
The Compliance Auditor performs detailed claim reviews, identifies coding and documentation risks, analyzes trends, develops recommendations for improvement, and delivers education to providers, coders, and operational teams. The ideal candidate enjoys analyzing complex claims and medical records, possesses exceptional attention to detail, can identify broader compliance and operational implications, and demonstrates a strong commitment to collaboration, education, and continuous improvement.
The successful candidate will possess advanced knowledge of healthcare coding, auditing, and compliance principles, with demonstrated expertise in Medical Oncology, Radiation Oncology, and Urology services. The ideal candidate is detail-oriented, analytical, committed to accuracy and continuous learning, and able to effectively balance detailed audit review with broader compliance risk assessment. Conduct coding, billing, and documentation audits to identify compliance, coding, and reimbursement risks.
Review medical records and claims to ensure compliance with regulatory, payer, and organizational requirements.
Analyze audit findings, identify trends and opportunities for improvement, and recommend corrective actions.
Prepare audit reports and communicate findings to leadership, providers, coders, and operational stakeholders.
Provide education and guidance to physicians, coders, and staff on coding, documentation, compliance requirements, and industry best practices.
Research coding and documentation questions to support accurate code assignment and reimbursement.
Assign and validate ICD-10-CM, CPT, HCPCS, and modifier usage for professional and facility services as applicable.
Coordinate responses to external audit and medical record requests and ensure timely submission of required documentation.
Maintain current knowledge of coding guidelines, payer policies, and healthcare regulations impacting Medical Oncology, Radiation Oncology, and Urology services.
Collaborate with Compliance, Revenue Cycle, Coding, Clinical, and Operational teams on monitoring activities and compliance initiatives.
Coding certification from an accredited source (AAPC, AHIMA, etc.)
~Undergraduate degree, preferred

Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to perform varied tasks and projects
May contribute to the development of policies and procedures
Works on complex projects of large scope
independently receives general guidance on new projects
Bonus eligible: Medical, dental and vision coverage

• Health savings account (HSA)
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Application window anticipated to close: 12/19/2026 if interested in opportunity, please submit application as soon as possible.

Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.
NYSE: CAH) is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for healthcare facilities.
We are a crucial link between the clinical and operational sides of healthcare, delivering end‑to‑end solutions and data‑driving insights that advance healthcare and improve lives every day. With deep partnerships, diverse perspectives and innovative digital solutions, we build connections across the continuum of care.
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