Clinical Revenue Auditor

6 days ago

New York, New York, United States Medix™ Full time


Clinical Revenue Auditor


New York, NY 10029


Full-Time | Exempt


Hybrid / Remote Option Available

Are you a clinically minded professional who understands how documentation, coding, and reimbursement come together? This is a unique opportunity to bridge
clinical care and revenue integrity
in a highly respected academic health system environment.

As a Clinical Revenue Auditor, you'll play a critical role in ensuring services provided to patients are accurately documented, coded, and reimbursed—while partnering closely with clinical, coding, billing, and revenue cycle leaders to drive compliance and financial performance.


What You'll Do

You'll serve as a key link in the revenue cycle, helping translate patient care into accurate and timely reimbursement.

  • Conduct detailed charge capture and clinical audits to validate documentation, coding, and billing accuracy
  • Identify missing or incorrect charges, coding discrepancies, and documentation gaps
  • Perform root cause analysis to address revenue leakage and develop corrective action plans
  • Ensure compliance with CMS regulations and other federal and state billing guidelines
  • Collaborate with clinical, billing, coding, and IT teams to improve workflows and documentation practices
  • Leverage charge capture software and analytics tools to identify trends and opportunities for improvement
  • Coordinate with payers on audit requests, technical denials, and appeal determination and tracking
  • Educate clinical teams on documentation and charge capture best practices
  • Build strong, collaborative relationships with revenue cycle and clinical stakeholders
  • Support continuous process improvement initiatives and compliance standards


What We're Looking For

  • Bachelor's degree in a healthcare-related field (Master's preferred)
  • 3–5 years of clinical experience with strong knowledge of medical terminology and patient care
  • Demonstrated success in a large academic, not-for-profit, or multi-entity health system environment
  • Strong understanding of medical coding systems, billing regulations, and reimbursement workflows
  • Hands-on experience with Epic and other medical billing or audit software
  • Knowledge of Medicare, Medicaid, managed care, and coordination of benefits
  • Excellent communication skills with the ability to work effectively with physicians and senior leaders
  • Strong analytical, organizational, and problem-solving skills
  • Ability to manage multiple priorities in a fast-paced environment


Licensure & Certifications (Preferred)

  • Active NYS clinical licensure (RN, OT, PT, SLP, PA, Social Worker, Lab or Radiology Technologist, or related)
  • Certifications such as CPMA, CIC, CCS, or CHA are a plus


Work Environment

  • Corporate office setting within an academic health system
  • Hybrid or remote work options available
  • Collaborative, mission-driven culture focused on quality and compliance


Why This Role Stands Out

  • Make a direct impact on revenue integrity and patient care quality
  • Work cross-functionally with clinical and executive leadership
  • Opportunity to influence education, compliance, and process improvement
  • Stability and growth within a large, complex healthcare system

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