What are the responsibilities and job description for the Compliance Auditor position at Oceanic Counseling Group, LLC?
About Us
Oceanic Counseling Group is a growing mental health practice serving clients across South Carolina. Our administrative team supports a clinical staff of therapists and counselors, and we're committed to accurate, ethical documentation that protects both our clients and our clinicians.
Position Summary
We're seeking a *highly* detail-oriented Compliance Auditor to review clinical documentation for accuracy, completeness, and adherence to payer and regulatory requirements. This role is central to ensuring clean insurance billing and reducing claim denials, and serves as our primary point of contact for external audits and records requests from insurance companies.
Key Responsibilities
- Audit clinical notes (intakes, treatment plans, progress notes, discharge summaries) against payer, state, and federal documentation requirements
- Serve as the primary point of contact for external audits initiated by insurance companies — coordinating record requests, compiling and submitting documentation, tracking deadlines, and communicating with payer representatives throughout the process
- Prepare responses to audit findings, including drafting appeals and corrective action documentation in coordination with leadership
- Verify that documentation supports medical necessity and aligns with billed CPT codes, diagnoses, and service dates
- Track and report compliance metrics; identify trends, recurring errors, and training opportunities
- Confirm timeliness, required elements, and signature/credentialing compliance on all reviewed notes
- Communicate audit findings to clinicians and leadership in a clear, constructive manner
- Support the billing team by resolving documentation issues tied to denials and appeals
- Assist in maintaining and updating internal documentation policies and audit tools
- Maintain strict confidentiality and HIPAA compliance in all work
Qualifications
Required:
- Associates degree or equivalent combination of education and relevant experience
- 3 years of experience in healthcare compliance, medical billing, clinical documentation review, or a related field
- Working knowledge of HIPAA and insurance documentation requirements
- Strong attention to detail and comfort working with EHR systems and spreadsheets
- Ability to work independently, manage deadlines, and communicate professionally
- Must pass background check
Preferred:
- Prior experience responding to payer audits
- Experience in behavioral health or outpatient mental health settings
- Familiarity with Medicaid, Medicare, and commercial payer requirements in South Carolina
- CPMA or CHC certifications
- Experience with EHR software
Schedule & Benefits
- Monday–Friday, 8:00 AM–5:00 PM, on site in Surfside Beach, SC
- Health/dental/vision insurance, PTO, paid holidays, matching 401k, etc.
Pay: From $17.50 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Application Question(s):
- How many years of experience do you have in medical billing or compliance?
Ability to Commute:
- Surfside Beach, SC 29575 (Required)
Work Location: In person
Salary : $18