23 jobs found

The Regional Business Office (MIDA) in Norfolk, Virginia, is seeking a full-time professional for an on-site position focused on performing medical record chart and coding audits for the US Oncology Network. This role requires adherence to compliance programs and established guidelines. We offer a competitive hourly pay range of $28-$38 based on experience, along with generous benefits including M/D/V, Life Insurance, 401(k), PTO, and Paid Holidays. Join us in the fight against cancer! #J-18808-Ljbffr

Overview Employment Type: Full Time On-Site Position Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays Norfolk, Virginia Pay Range $28-$38 hourly based on experience Job Scope With general supervision of the State Reimbursement Manager, performs complete medical record chart and coding audits for medical and radiation oncology physicians, per the US Oncology Network's established guidelines. Supports and adheres to The US Oncology Compliance Program, to include the Code of Ethics and Business Standards. About US Oncology The US Oncology Network is a thriving organization that fosters forward‑thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join our team in the fight against cancer! The US Oncology Network is one of the nation’s largest networks of community‑based oncology physicians dedicated to advancing...

US Oncology Inc. is looking for a skilled professional in Norfolk, Virginia, to perform medical record chart and coding audits under the supervision of the State Reimbursement Manager. This full-time, on-site role involves ensuring compliance with established guidelines and providing insight for procedural improvements. The ideal candidate will have at least nine years of experience in billing and coding, a CPC certification, and strong knowledge of ICD9, CPT4, and HCPCS codes. We offer a comprehensive benefits package including medical, dental, vision, 401(k), and more. #J-18808-Ljbffr

Job Duties Oversee the management of multiple projects. Manage client needs and expectations to ensure projects meet scope, requirements and deliverables are on-time and of high quality. Perform production work in addition to project management, meeting department’s quality and production standard thresholds. Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines. Review auditor work for accuracy and provide feedback written and verbally to auditors. Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, and diagnoses and meet department quality and production standards. Research regulatory guidelines for supporting documentation. Prepare audit summary findings, providing detailed comments related to the audit findings and make recommendations. Support team with department key performance indicators and goals (SLAs). Embrace workforce...

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies,...

Job Description Job Description Description: A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements: Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Conducting audits of medical records, the full-time Certified Medical Auditor will evaluate the accuracy of medical coding and compliance with health plan policies for Fraud, Waste & Abuse clients while working remotely. Key responsibilities Conduct audits of medical records and healthcare claims to assess coding accuracy and compliance with policies and regulations Prepare and submit detailed reports on audit findings, providing recommendations for improvements Research medical policies and relevant guidelines to support review findings Required qualifications Bachelor's Degree in a related discipline or equivalent combination of education and experience Certified Professional Coder (CPC, CCS, CCS-P) credential required 2-5 years of related experience in auditing medical records Proficiency in MS Office suite Understanding of ICD, CPT, HCPCS, and federal and state guidelines

                                          Remote | Work from Home | Healthcare Consulting   Help Healthcare Organizations Improve Documentation, Compliance, and Reimbursement Integrity   About Compass  At Compass, as professional fee auditors, we do more than review charts. We partner with healthcare organizations to improve documentation quality, coding accuracy, compliance, provider performance, and financial outcomes. Our clients rely on us for expert guidance, practical recommendations, and meaningful education that creates lasting results.   The Opportunity  Are you a detail-oriented coding and documentation professional who is passionate about improving coding accuracy, strengthening clinical documentation, and helping healthcare organizations achieve operational and financial success? If so, we invite you to consider our growing consulting team.   As a Coding, Billing & Clinical Documentation Improvement...

Job Type Full-time Description A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations. Requirements Key Responsibilities: Medical Documentation Review: Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation. Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information. Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and...

Managing multiple projects remotely, the full-time Medical Auditor Project Lead will oversee client needs, perform production work, maintain audit standards, and provide feedback to auditors while ensuring high-quality deliverables. Key responsibilities Oversee project management and client expectations to ensure timely and quality deliverables Audit medical records and validate clinical documentation to meet quality standards Prepare audit findings and provide recommendations based on detailed analysis Required qualifications CPC certification required; CPMATM or RHIT preferred Extensive experience in coding, billing, auditing, and compliance within the healthcare industry Proficient knowledge of AMA, OIG, CMS, and national coding guidelines Experience in developing training materials and delivering presentations Demonstrated ability to manage multiple projects simultaneously

Working remotely full-time, a Certified Medical Auditor (NC) will perform validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events, while coordinating rate adjustments and providing reports on trends in medical records management. Key responsibilities Conducts validation reviews and coordinates rate adjustments with claims areas, creating reports on outcomes and trends Manages records retrieval, release, and HIPAA compliance, overseeing all aspects of document management Acts as an expert resource for medical records and coding issues, providing guidance on methodology and procedures Required qualifications Associate's degree in a job-related field or equivalent experience (2 years of job-related work experience) 3 years of experience in medical record management, including coding and validation review Registered health information administrator (RHIA), Registered health information technician (RHIT), Certified Professional Coder...

Managing multiple projects remotely, the full-time Medical Auditor Project Lead will oversee client needs, perform production work, maintain audit standards, and provide feedback to auditors while ensuring high-quality deliverables. Key responsibilities Oversee project management and client expectations to ensure timely and quality deliverables Audit medical records and validate clinical documentation to meet quality standards Prepare audit findings and provide recommendations based on detailed analysis Required qualifications CPC certification required; CPMATM or RHIT preferred Extensive experience in coding, billing, auditing, and compliance within the healthcare industry Proficient knowledge of AMA, OIG, CMS, and national coding guidelines Experience in developing training materials and delivering presentations Demonstrated ability to manage multiple projects simultaneously

Conducting audits of medical records, the full-time Certified Medical Auditor will evaluate the accuracy of medical coding and compliance with health plan policies for Fraud, Waste & Abuse clients while working remotely. Key responsibilities Conduct audits of medical records and healthcare claims to assess coding accuracy and compliance with policies and regulations Prepare and submit detailed reports on audit findings, providing recommendations for improvements Research medical policies and relevant guidelines to support review findings Required qualifications Bachelor's Degree in a related discipline or equivalent combination of education and experience Certified Professional Coder (CPC, CCS, CCS-P) credential required 2-5 years of related experience in auditing medical records Proficiency in MS Office suite Understanding of ICD, CPT, HCPCS, and federal and state guidelines

Working remotely full-time, a Certified Medical Auditor (NC) will perform validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events, while coordinating rate adjustments and providing reports on trends in medical records management. Key responsibilities Conducts validation reviews and coordinates rate adjustments with claims areas, creating reports on outcomes and trends Manages records retrieval, release, and HIPAA compliance, overseeing all aspects of document management Acts as an expert resource for medical records and coding issues, providing guidance on methodology and procedures Required qualifications Associate's degree in a job-related field or equivalent experience (2 years of job-related work experience) 3 years of experience in medical record management, including coding and validation review Registered health information administrator (RHIA), Registered health information technician (RHIT), Certified Professional...

Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. Day in the Life of a Medical Coding Auditor Conducting audits of claims and patient records to identify incorrect coding. Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines. Developing, implementing, and coordinating corrective action proposals and plans. Tracking completion of internal and external Plans of Correction....

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

MetroPlus is seeking a Clinical Coder to join its Special Investigations Unit in New York City. The candidate will review medical records and claims for compliance, conduct audits, and participate in investigations of suspected fraud. A Bachelor's degree in Nursing and AAPC Coding certification are required, along with 5+ years of relevant experience. Strong analytical skills and attention to detail are essential for success in this role. The position allows for hybrid work arrangements, promoting both collaboration and work-life balance. #J-18808-Ljbffr

At South Shore Health, we come together to improve the health of our family, friends and neighbors by bringing together people, caregivers and excellence in medicine. We are seeking a Coding and Compliance Auditor to evaluate medical record documentation and coding accuracy, identify opportunities for improvement, and design and deliver coding education and training programs for clinical staff, coders and other key stakeholders. In this role, you will monitor external regulatory and internal process changes and provide support to colleagues in adhering to Federal, State and local requirements. The annual pay range for this role is $73,000.00 - $104,400.00.   Responsibilities: ·        Establish, implement, and maintain a formalized process for coding compliance and a formal review (audit) process, and conduct routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPCs, PCS and ICD-10-CM codes ·        Perform prospective...

Sr. Auditor Project Lead The Sr. Auditor Project Lead will report to the Manager with a direct line of communication to the Directors. Responsibilities will include but not be limited to: Oversee the management of multiple projects. Manage client needs and expectations to ensure projects meet scope, requirements and deliverables are on-time and of high quality. Perform production work in addition to project management, meeting department's quality and production standard thresholds. Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines. Review auditor work for accuracy and provide feedback written and verbally to auditors. Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, and diagnoses and meet department quality and production standards. Research regulatory guidelines for supporting documentation. Prepare audit summary...

A leading AI research accelerator is seeking a medical professional to provide expertise in internal or emergency medicine to refine AI models like ChatGPT. Responsibilities include designing complex clinical scenarios, evaluating diagnostics, and collaborating with researchers. Candidates must possess an MD with recent practice and strong communication skills. This role is fully remote, requiring 20–40 hours per week with a 1-month initial duration and the possibility of extension. J-18808-Ljbffr