23 compliance coding auditor jobs found in San Diego, CA

Compliance Coding Auditor The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in oversight of Sharp HealthCare's (SHC) compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits. Required Qualifications: 5 Years experience in acute care inpatient/outpatient coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. Preferred Qualifications: Strong...

Compliance Coding Auditor page is loaded## Compliance Coding Auditorlocations: System Services-Telecommutertime type: Full timeposted on: Posted 30+ Days Agojob requisition id: JR180837**Hours****:****Shift Start Time:**Variable**Shift End Time:**Variable**AWS Hours Requirement:**8/40 - 8 Hour Shift**Additional Shift Information:****Weekend Requirements:**No Weekends**On-Call Required:**No**Hourly Pay Range (Minimum - Midpoint - Maximum):**$49.700 - $64.130 - $71.820The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. \*This is a remote position\***What You Will Do** The Compliance Coding Auditor is responsible for the...

Overview Compliance Coding Auditor role at Sharp HealthCare. Hours: AWS Hours Requirement: 8/40 - 8 Hour Shift. Shift Start Time: Variable. Shift End Time: Variable. Weekend requirements: No weekends. On-call: No. The stated pay scale is $48.140 - $62.110 - $76.080, with actual pay dependent on factors including experience, skills, education, and internal considerations. The role supports Sharp HealthCare's compliance audit program, focusing on coding, billing, and reimbursement audits to prevent and detect violations and promote compliant practices. What You Will Do Administer Sharp HealthCare’s compliance audit program and oversee high-quality coding, billing, and reimbursement audit activities. Provide oversight of the coding, billing, and reimbursement compliance audits and report findings to stakeholders; propose corrective actions as needed. Review electronic health records to identify potential coding and billing compliance issues and prepare written audit reports with...

Join to apply for the Compliance Coding Auditor , ATM role at Advanced Medical Management, Inc. Your actual pay will be based on your skills and experience. Talk with your recruiter to learn more. Base pay range: $75,000 to $80,000 per year. Role Overview As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients, families, and government agencies. The Program is led by AMM’s Chief Compliance & Ethics Officer, who reports to the CEO and the Board, and oversees the AMM Compliance Committee. This role requires sound, risk‑aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to...

A healthcare provider in San Diego seeks a Compliance Coding Auditor to oversee compliance audits related to coding and billing practices. The role involves ensuring adherence to regulations, conducting audits, and providing reports to improve compliance within the organization. A Bachelor's degree and relevant experience in coding are required. Certification in clinical documentation improvement is preferred. The position also demands excellent communication skills and the ability to function in a fast-paced environment. #J-18808-Ljbffr

A leading healthcare provider in San Diego is seeking a Compliance Auditor to ensure accurate coding and documentation practices. Candidates should have a strong understanding of CPT and ICD-10 codes and experience in medical record auditing. The role involves conducting audits, providing training, and supporting clinical staff for compliance with CMS standards. Competitive hourly pay is offered, aligning with industry standards. #J-18808-Ljbffr

A healthcare provider in San Diego is seeking a Coding Auditor to conduct audits and ensure compliance with coding standards. The role requires strong knowledge of CPT and ICD-10 codes, exceptional communication skills, and the ability to train clinical staff. The ideal candidate has 3 years of experience in a healthcare setting and holds a CPC or CCS-P certification. Competitive hourly rate offered. #J-18808-Ljbffr

Compliance Auditor - SRS Join to apply for the Compliance Auditor - SRS role at Sharp HealthCare . Shift Information Flex hours: 6:00‑9:00 am to 2:30‑5:30 pm Weekend requirements: As needed On‑call required: No AWS Hours Requirement: 8/40 – 8 Hour Shift Variable shift start and end times Hourly Pay Range: $34.17 - $44.09 - $49.37 What You Will Do Identify and report coding and documentation practices, making recommendations to ensure accurate reporting of services provided by clinical providers and to support implementation of correct coding standards as established by SHC Corporate Compliance in accordance with CMS and local MAC requirements. Required Qualifications 3 years of experience auditing coding and medical record documentation in an ambulatory care setting. Experience developing training materials and presenting to a large group of professionals. Certified Professional Coder (CPC) – AAPC or Certified Coding Specialist – Physician‑based (CCS‑P) (AHIMA) –...

A leading healthcare provider in Newport Beach, California is seeking a Coding Auditor and Educator to perform coding audits and ensure compliance with federal and state regulations. The ideal candidate should have a bachelor's degree, CCS credential, and 8-10 years of experience in coding and auditing. This role involves preparing audit reports and educating hospital staff on findings. Competitive salary and full-time position offered. #J-18808-Ljbffr

Coding Auditor and Educator - Medical Coding Department: Business Services Status: Full Time Shift: 1st Location: US Under the Direction of the Coding Manager, performs/facilitates departmental, interdepartmental and external coding audits to ensure quality completeness and accuracy of coding; compliance with Federal and State Regulations; and appropriate reporting. Provides education based on audit findings. Has thorough knowledge of Acute Care Facility Federal and State reporting guidelines, modifiers, sequencing rules, and the NCCI (National Correct Coding Initiative) edits, Official Guidelines for Coding and Reporting for ICD-10-CM, ICD-10-PCS, CPT-4 coding conventions, DRG and APC payment classifications and Medicare Conditions of Participation. Essential Functions Serves as subject matter expert on hospital performance improvement committees Response to coding questions from outside departments and provides coding references and guidelines Performs retrospective and...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Multispecialty Surgery Coder II The Multispecialty Surgery Coder II will code for multispecialty surgery physicians primarily single path coding. Multi-specialty surgical coding experience, any trauma, urology, ENT, plastics, gen surg, OB/GYN, cardiovascular, interventional radiology, etc. Ability to extract data and apply appropriate ICD-10 diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM official guidelines for coding and reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve...

Shared Services: Compliance- (Full-Time, Day Shift) - Job Summary: The Compliance Auditor-Physician monitors and audits established mechanisms and controls to ensure compliance with regulations. Audits the activities of various departments for compliance with plans, policies and procedures prescribed by management. Prepares and submits reports on the results of audits, recommending improvements in policies and procedures. Cooperates with outside auditors in any undertaking that may expedite their work. Performs other duties as needed. Conducts full range of physician-based audits/projects and develops partnerships with internal and external customers. Performs other duties as needed. Education and Experience: Bachelor's Degree required. Master's Degree preferred. Minimum three years of experience in auditing within healthcare, compliance, regulatory oversight agency, quality management, quality assurance or business analysis. Knowledge and Skills: Experience with...

Outpatient Facility-Clinic Medical Coder (Multi-Specialty) Part-Time We are seeking a detail-oriented and analytical Outpatient Facility-Clinic Medical Coder (Multi-Specialty) to join our remote US-based coding team. In this role, you will be responsible for accurately assigning diagnostic and procedural codes for various medical specialties in an outpatient setting. The ideal candidate will have a strong understanding of medical coding principles and healthcare regulations. Schedule & Compensation This is a part-time position (2030 hours per week) with a pay range of $30$40 per hour. Initial training will be conducted during standard business hours (MondayFriday, 8 a.m.5 p.m.) for approximately 2030 hours per week. Following training, work hours can transition to a flexible schedule. Job Description Analyze patient medical records and assign appropriate ICD-10-CM, CPT, and HCPCS codes for outpatient services across multiple specialties Ensure coding accuracy and...

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Job Summary We are currently seeking a detail-oriented and dedicated Medical Biller to join our team. In this role, you will be responsible for managing the billing and collection of outstanding account balances for Medi-Cal and managed care payors . You will analyze and interpret complex payor contract language to calculate expected reimbursements accurately and ensure timely collection of all payments owed to the organization. Responsibilities Process medical billing and follow up on claims with Medi-Cal and managed care payors Audit and evaluate clinical documentation and billing records to ensure they are accurate, timely, clinically appropriate, justify medical necessity for Medi-Cal reimbursement, and comply with all State and County...

Company Description *Candidate should ideally be located in San Diego, CA, Las Vegas, NV or San Francisco, CA* Monro's family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto...

Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Flex hours are 6:00-9:00 am to 14:30-17:30 pm Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $34.170 - $44.090 - $49.370 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do To identify and report coding and documentation practices and make recommendations which assure the accurate reporting and documentation of services provided by entity clinical providers. To support and facilitate...

Vista Community Clinic (VCC) At Vista Community Clinic (VCC), we believe healthcare is more than medicine, it's about hope, community, and impact. For over 50 years, we've been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it's needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. Benefits include: Competitive compensation & benefits Medical, dental, vision Company-paid life insurance...

Job Description Job Description Description: We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations. Requirements: Responsibilities Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues Follow up on claims using...

Job Description Job Description Salary: $30hr-$35hr DOE Job Title: Coder (Billing) Salary: $30-$35hr DOE Location: Treehaven Openings: 1 Position Purpose: The Jr. Coder is responsible for accurately assigning standardized codes to diagnoses, procedures, and treatments for patient records, insurance claims, and billing processes. This role ensures compliance with applicable coding standards, regulations, and payer policies to facilitate timely and accurate reimbursement. Core Duties and responsibilities, include but are not limited to: Reviewing patient charts to accurately assign the appropriate billing codes (ICD-10-CM, CPT, HCPCS) for diagnoses, procedures, and services rendered, in accordance with FQHC requirements across all lines of business Assist in the submission of accurate claims to payers after correction Ensuring coding compliance with federal and state regulations as well as insurance requirements Communicate with patients and insurance companies to...

Hospital/Facility Revenue Cycle Manager Trajectory RCS joined the MedHQ family in the beginning of 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through teamwork and collaboration. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. The MedHQ LLC service line offerings have grown organically over the years, beginning by providing high quality traditional human resource, accounting, and staff...

Medical Record Coder At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline. Meets and maintains HIM coding quality and...

Job Description Job Description Job Summary Medical Biller The Medical Biller reports to the Billing Manager in person at our office in Ontario, CA and is responsible for the accurate, compliant, and timely billing of clinical laboratory services, including blood testing, microbiology/culture testing, and toxicology services. This role requires strong expertise in Medicare Part A vs Part B billing, skilled nursing facility (SNF) workflows, and commercial payer laboratory billing rules. The Medical Biller manages claims from Pending Review through payment resolution while ensuring full compliance with Medicare, Medicaid, and commercial payor regulations. No remote work available Supervisory Responsibilities None Essential Duties and Responsibilities Laboratory Billing & Claims Management Review laboratory patient demographics, insurance, ordering provider, and facility information. Prepare, review, and submit insurance claims for laboratory...