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Wellpath

Outsourced correctional healthcare services provider

Compliance Analyst

Regulatory Compliance & EthicsPosted on Nov 10
Full-timeFranklin, TN, USANo salary listed

About the Job

Requirements

  • An associate's degree in Health Information Management, Health Sciences, Business, or a related field is preferred.
  • A bachelor's degree is preferred.
  • Completion of a formal coding training program through AAPC, AHIMA, or an equivalent organization is required.
  • Equivalent professional coding credentials and experience may substitute for formal education.
  • At least three years of professional medical coding, billing, or coding-audit support experience is required.
  • Working knowledge of CPT, HCPCS Level II, ICD-10-CM, and modifier guidelines is required.
  • Experience with electronic medical record systems, encoders, and claims or billing workflows is required.
  • Familiarity with CMS, OIG, AMA, and payer documentation and coding requirements is required.
  • Exposure to state Medicaid coding rules, Section 1115 Reentry Demonstration billing requirements, and correctional health workflows is required.
  • A Certified Professional Coder credential through AAPC is required.
  • The Certified Professional Medical Auditor credential through AAPC is preferred or must be obtained within the first 12 months of employment.
  • The Certified Professional Biller credential through AAPC is preferred.
  • A Certified Coding Specialist credential through AHIMA may substitute for an AAPC equivalent.
  • Applicants must reside in the United States.

Responsibilities

  • Conduct routine coding reviews and audits to ensure accurate CPT, HCPCS, ICD-10-CM, and modifier use.
  • Collect, organize, and validate audit data while maintaining audit workpapers and tracking logs.
  • Prepare monthly, quarterly, and ad hoc compliance reports and analyze data to identify trends and risks.
  • Support vendor audits and compliance efforts by reviewing documentation, comparing claims, and tracking remediation activities.
  • Assist with complex audits, regulatory inquiries, and education materials, and maintain audit tools and documentation.

Desired Qualifications

  • Experience supporting audits or oversight of third-party billing vendors is preferred.
  • Previous correctional or detention facility experience is preferred.

About the Company

Wellpath

Outsourced correctional healthcare services provider

Wellpath provides outsourced healthcare for inmates in the United States and Australia through government contracts, covering medical, dental, optical, and mental health services. Its offerings include primary care, chronic disease management, substance abuse and detox programs, suicide prevention, pharmaceutical management, and administrative tasks such as revenue cycle management, all using its proprietary ERMA electronic records system. The company operates at scale with divisions serving local jails, state and federal prisons, and inpatient facilities, reaching about 300,000 patients daily across more than 550 facilities. Its goal is to deliver comprehensive, contract-based correctional healthcare while navigating sector challenges like debt, rising labor costs, and litigation risk.

Company size
1,001-5,000
Company stage
Early VC
Total funding
$10.7M
Headquarters
Nashville, TN
Founded
2006

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