24 coding auditor jobs found in Los Angeles

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Job Description Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What Will I be Doing in this Role? Under the general direction of the HID Audit Supervisor, the role operates as a Coding Auditor and shall: Monitor coding compliance through prebill and retrospective reviews or audits of ICD and/or CPT codes assigned by coding staff. Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS)....

A leading medical institution in Los Angeles is seeking a Coding Auditor to ensure compliance in coding practices through audits and education. The ideal candidate has a degree in health information management and certifications such as RHIT or CPC. Responsibilities include monitoring coding compliance, providing training for coders, and assisting with coding during staff shortages. Join a diverse team that values excellence and innovation in healthcare. #J-18808-Ljbffr

A leading healthcare organization in the United States seeks a qualified individual for a role focused on conducting audits and reviews of medical records ensuring compliance with regulations. The role involves mentoring staff, communication with regulatory bodies, and a strong understanding of ICD coding and risk adjustment processes. Candidates need at least 5 years of relevant experience and necessary certifications. This full-time position offers a competitive salary range of $46,988 - $112,200 along with comprehensive benefits. #J-18808-Ljbffr

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure...

Description Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: * Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre-delegation reviews, and...

*Description* The HCC Auditor/Coder's primary objective is to continually improve providers' reporting and documentation of chronic health care conditions. This is done through auditing providers' patient medical records and providing education on best coding practices. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface effectively with physicians and office staff on coding issues. Research coding questions as needed. Code review a wide variety of document types, i.e., Primary and specialty care medical records, mental health, substance abuse, in-patient, out-patient, non-submittals (lab), ancillary and pharmaceutical services for HCC values. Perform both provider office audits and on-line audits via reviewing patient medical records. Provide education to...

A leading health company in California is seeking a Clinical Provider Auditor II to identify potential fraud and abuse risks in the healthcare system. This hybrid position requires strong skills in medical coding, with responsibilities including examining claims for compliance and collaborating on internal investigations. Candidates must have a minimum of 3 years of medical auditing experience and relevant coding certifications. Join a workplace that values community health and offers competitive rewards. #J-18808-Ljbffr

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

HealthCare Support is seeking a Risk Adjustment Coder - Hybrid to join a mission-driven healthcare organization in Monterey Park, CA . This full-time, salaried role offers the flexibility of hybrid work combined with in-market provider engagement. Schedule: Monday – Friday, 8:00 AM – 5:00 PM PST Compensation: $75K - $85K (negotiable based on experience) What Makes This Role Stand Out Strong Work-Life Balance with a primarily remote schedule Provider-facing education and real-world impact in risk adjustment Opportunity to serve as a senior resource, mentor, and subject matter expert Competitive compensation and comprehensive benefits package Benefits For The Risk Adjustment Coder - Hybrid Medical, Dental, and Vision Insurance Complimentary access health plan option 401(k) Retirement Plan with match Paid Time Off (PTO) Employee Stock Purchase Plan Daily Responsibilities For The Risk Adjustment Coder - Hybrid Review and audit medical records for accurate ICD-10 and HCC risk...

A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we've helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. The ideal candidate is detail-oriented, tech-savvy, and experienced in medical billing systems and procedures. Key Responsibilities Daily Billing Operations Reconcile billing records for accuracy,...

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

Benefits: Employee discounts Training & development Wellness resources Role Overview Own the end-to-end medical billing lifecycle for a multi-specialty healthcare clinic. Drive clean claims, fast reimbursements, and zero leakage. This is an execution-heavy, accountability-driven role—not a passive billing position. Core Responsibilities Manage full-cycle billing: charge entry, claim submission, payment posting, and follow-up. Bill and reconcile across multiple payor types: Commercial insurance Medicare Personal injury (PI) Workers’ compensation Cash-based services Ensure accurate CPT, ICD-10, and modifier usage across: Medical Chiropractic Physical therapy Acupuncture Massage therapy Aggressively work A/R: Identify denials, underpayments, and delays. Execute timely appeals and corrections. Maintain compliance with: Medicare rules State and federal billing regulations Payor-specific policies Communicate clearly with:...

Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Essential Duties and Responsibilities: • Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit • HEDIS coding and record collection • Report Coding discrepancies patterns identified within the chart review process to the Coding...

Creative Audio is a centralized team that touches every product Meta produces, making our team integral to the company. We collaborate with product and creative teams across Meta to design audio for video, post-production audio, final mixing and mastering, audio field recording, sound effects, and large scale content projects across a wide range of software and hardware, including but not limited to your phone, glasses, VR headsets a mix of Augmented Reality/Mixed Reality across these devices. We're a team of over 60 audio experts who design the experiences that connect people through the power of sound. The Creative Audio team is seeking a Creative Coder for the Tech & Prototypes department. This role collaborates closely with Engineering and Product Design to define sound functionality and deliver advanced audio systems. It involves developing advanced audio solutions, optimizing performance, refining tools, and solving complex technical challenges. As a key contributor to...

Title: Medical Biller Base Salary Range: $23.00 Hourly plus benefits FTE : Full Time - Non - Exempt We are seeking an experienced and diligent Medical Biller who wants to make a difference in our community. We want to hear from you if you thrive in a fast-paced, caring, and compassionate environment! Our Mission: The Mission of South-Central Family Health Center is to improve the quality of life for the diverse community of inner-city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services. General Summary: Under the supervision of the Revenue Cycle/Billing Administrator, the Medical Biller I will be responsible for the processing and responding to all patient-related billing and the submission...

Summary Creative Audio is a centralized team that touches every product Meta produces, making our team integral to the company. We collaborate with product and creative teams across Meta to design audio for video, post‑production audio, final mixing and mastering, audio field recording, sound effects, and large‑scale content projects across a wide range of software and hardware, including but not limited to your phone, glasses, VR headsets, and a mix of Augmented Reality/Mixed Reality across these devices. We’re a team of over 60 audio experts who design the experiences that connect people through the power of sound. The Creative Audio team is seeking a Creative Coder for the Tech & Prototypes department. This role collaborates closely with Engineering and Product Design to define sound functionality and deliver advanced audio systems. It involves developing advanced audio solutions, optimizing performance, refining tools, and solving complex technical challenges. As a key...

A leading social media and technology company in Los Angeles is seeking a Creative Coder for its Creative Audio team. This role involves developing cutting-edge audio solutions, collaborating with design and engineering teams to enhance sound functionalities across a variety of platforms. Candidates should have extensive experience in coding, proficiency in multiple programming languages, and a strong understanding of audio processing. The position offers a competitive salary package including bonuses and equity. #J-18808-Ljbffr

Job Description Job Description Position Purpose: Under the direct supervision of the Director of Quality Assurance, the Licensed Nurse is responsible for supporting the compliance functions of the Quality Assurance and Performance Improvement department of JWCH. The responsibilities include: Maintaining defined review schedule for JWCH agency by (1) doing preparatory work for the audit including developing a scope of work, (2) reviewing the documentation, (3) preparing reports, (4) doing any necessary follow-up reviews and (5) ensuring that appropriate collected data are securely kept and maintained. Serve as a resource to clients in answering compliance questions from Internal Audit and Audit Advisory Services and assisting as necessary in their audit process. Essential Duties and Responsibilities : Conduct Compliance Reviews Complete compliance reviews within established parameters and initiate and carry out all assigned reviews according to defined...

Job Summary Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...

Position Purpose The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy. Collaborate with clinicians on the correct use of...

A healthcare organization in Los Angeles is seeking a Certified Medical Coder to ensure accurate coding of medical services. This role involves liaising between providers and the Billing Department, recommending appropriate coding, and conducting audits. Candidates should have a medical coding certificate and two years of experience. The position offers a competitive pay and benefits package for those working over 30 hours per week, including medical, dental, vision, and paid time off. #J-18808-Ljbffr

Job Summary Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...