34 auditor jobs found

WelbeHealth Paced Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Shift: 5:00AM-Finish 2:00PM-Finish 4:00PM-Finish Schedule set at time of hire Compensation: $19.00 per hour - Weekly Pay! Phoenix, AZ Pay: $19.00/ hourly Hiring all shifts! | Schedule set at time of hire Vendor Compliance Auditor JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations #CB Capstone Logistics, LLC is part of The Transportation and Logistics industry which has been designated a "Critical Infrastructure Segment". As a "critical infrastructure industry" worker in the Transportation and Logistics industry, associates are...

Empowering Wellness, Transforming Lives Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being. As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities. Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full...

A leading health solutions company in Scottsdale is seeking a full-time auditor to perform total store audits and provide insights on operational accuracy and product quality. The ideal candidate will have a high school diploma and working knowledge of problem-solving skills. This position offers a pay range of $17.00 - $25.65 per hour and benefits including a 401(k) plan and wellness programs. The goal is to enhance compliance and operational efficiency across distribution centers. #J-18808-Ljbffr

A leading healthcare company seeks an experienced Inpatient Medical Coding Auditor to extract clinical information and ensure accurate reimbursement processes. This role involves reviewing hospital claims and making crucial coding decisions while working in a metrics-driven environment. Ideal candidates will possess relevant certifications and experience in inpatient coding, with strong attention to detail and excellent communication skills. The position is remote, but may require occasional travel for training, offering competitive compensation and a supportive benefits package. #J-18808-Ljbffr

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy...

A healthcare company is seeking a Medical Coding Auditor to ensure the accuracy of code assignments for medical claims. This remote role involves reviewing claims and documentation, conducting peer reviews, and maintaining coding compliance. Candidates should have at least 3 years of post-certification coding experience and strong knowledge of CPT/HCPCS codes. Humana offers competitive benefits and a flexible work environment, emphasizing both professional development and employee well-being. #J-18808-Ljbffr

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading financial services firm in Chandler is seeking a Compliance Assistant to ensure mortgage files meet compliance standards. In this full-time, in-office role, you will audit loan files and work closely with compliance and operations teams. Ideal candidates should have at least 1 year of experience in mortgage processing, a strong understanding of compliance regulations, and excellent analytical and communication skills. Join a people-focused company committed to accuracy and quality. #J-18808-Ljbffr

A leading distribution company in Tolleson, Arizona, is seeking a dedicated individual to manage trailer inspections and ensure that all operating procedures are followed. The role involves taking detailed inventory, monitoring trailer conditions, and documenting findings accurately. Strong attention to detail is critical as you will oversee trailer seals, fuel levels, and temperature compliance. This position offers a 3rd shift schedule and operates within a supportive team environment. #J-18808-Ljbffr

Job Description Job Description The Coding Network, LLC (TCN) is the country’s premier broker of remote coding and auditing services, structured as a virtual company connecting healthcare professionals and health systems across the country with over 800 US based single specialty coders and auditors. Flexible Hours: We understand that everyone’s schedule is different and, as such, auditors enjoy the flexibility to commit to as few as 15 hours a week to however many hours work for them to render auditing services. It is one thing to have the freedom to work from home, but TCN coders possess the freedom to utilize the full 24 hour clock and choose when to work beyond the traditional 9-5. Whether you’re looking for extra income in addition to your day job or to make a more robust commitment, we are able to accommodate you. Position & Responsibilities: In order to support the growing need for E&M services and surgical divisions, there are abundant opportunities for...

A leading health network in Arizona is seeking a detail-oriented professional for a medical coding role. Responsibilities include ensuring the accurate assignment of codes, complying with medical coding guidelines, and conducting audits for adherence to regulations. The ideal candidate will possess strong analytical skills and be knowledgeable about insurance regulations. This role includes travel between network sites and may require evening or weekend hours as needed. #J-18808-Ljbffr

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Job Opportunity: Inpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our...

Job Description Job Description About Optima Medical: Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation's top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and dedicated professionals aboard. We are currently seeking a Medical Coding Specialist to join our team! This role will transition to a fully remote position after your first 60 days. To be eligible, you'll need to complete your...

Job Description Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas....

Job Description Job Description Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Position Summary The Medical Biller is responsible for managing the full revenue cycle for a small, fastpaced family practice. This role ensures accurate claim submission, timely payment posting, denial management, and patient billing. The ideal candidate is detailoriented, reliable, and able to work independently while maintaining strict compliance with payer rules and practice policies. Key Responsibilities Claims & Billing Prepare, review, and submit clean claims to insurance carriers (electronic and paper). Verify coding accuracy and ensure all required documentation is present before submission. Correct and resubmit rejected or denied claims promptly. Maintain uptodate knowledge of CPT, ICD10, and payerspecific billing guidelines. Payment Posting & Reconciliation Post insurance and patient payments accurately into the practice...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and...

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and procedural codes for outpatient and professional services. This role requires advanced knowledge of coding guidelines and payer‑specific requirements to support correct billing, compliance, and optimal reimbursement. The PB Coder II works with minimal supervision and may assist with training or mentoring entry‑level coders. Responsibilities Review and interpret...