52 auditor supervisor jobs found

Job Description Job Description We are hiring for the position of Shift Front Desk Supervisor/Night Audit, the right candidate will work two shifts of Night Audit and three other shifts as a Shift Front Desk Supervisor. PREVIOUS HOTEL EXPERIENCE REQUIRED. Overview: The main responsibility is to audit and balance daily transactions and reports accurately. Responds in a professional and courteous manner to telephone and in-person inquiries regarding reservations, hotel information and guest concerns. Front Office Duties: Understand and perform all audit procedures Performs any other duties requested by supervisor, and be able to work all shifts as needed Maintain a positive work environment Maintain high guest satisfaction standards Fully understand and be able to operate all office equipment

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...

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)....

Job Description Job Description About Us Allstar Ambulance is a provider of Basic Life Support (BLS) Interfacility Transport (IFT) service. We are committed to safe, efficient, and compassionate care while supporting our EMT crews with strong leadership and growth opportunities. We’re currently hiring an EMT Supervisor to help manage daily operations and support field staff. Responsibilities Supervise and support BLS EMT crews during transport operations Oversee shift assignments, breaks, and vehicle readiness Serve as a liaison between field crews, dispatch, and management Respond to incidents or complaints; provide real-time guidance in the field Monitor and ensure compliance with state, local, and company protocols Assist with new employee training and performance feedback Conduct equipment, vehicle, and documentation audits as needed Participate in safety, quality assurance, and operational meetings Qualifications Valid EMT certification...

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...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

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...

Internal Reference Number: R1049162 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! This open position is within one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial...

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...

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 out 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 services...

Job Description Job Description 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....

Job Title: Medical Biller II Salary: $25hr-$28hr DOE Location: Tustin, CA Openings: 1 Position Purpose: The Medical Billing Specialist II supports the revenue cycle team by independently performing a broad range of billing functions with moderate complexity. This role is responsible for accurate insurance verification, charge entry, claim submission, payment posting, and resolution of routine denials to ensure compliance with payer requirements and timely reimbursement. Core Duties and responsibilities, include but are not limited to: Insurance & Eligibility Verification Verify complex insurance coverage (Medi-Cal, Medicare, Managed Care, Commercial, PPO/HMO). Research and resolve discrepancies in patient coverage or eligibility. Document eligibility outcomes in the EHR/PM system. Charge Entry & Coding Support Perform charge entry and apply CPT, ICD-10, and HCPCS codes. Review encounter forms for accuracy; flag missing or incorrect...

Lead Medical Biller Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is in-person at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead the training and mentorship of new billing hires, ensuring...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

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 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 diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

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...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

Spring Lake Village - On-site position Pay Range: $28.44 - $33.72 Summary: Under the supervision of the Nursing Home Administrator the Medical Billing Specialist prepares all Skilled Nursing facility private pay, insurance, secondary insurance, Medicare and Medi-Cal billing and completes related accounting functions. Serves as the community information systems liaison with the Home Office Accounting Department. Essential Functions: Provides quality Customer Service efficiently to residents, families, co-workers and vendors in a manner to ensure satisfaction. Prepares all Skilled Nursing Facility private pay, insurance, secondary insurance and Medicare, Medi-Cal and HMO billing and completes related accounting functions. Responsible for all accounting related to documenting, preparing, and distributing Care Center resident statements. May also be responsible for and/or assist with Residential receivables/billing. Responsible for aging/past-due account...

Overview We are recruiting for an exciting leadership opportunity as a Medical Assistant Supervisor for experienced or lead MA's at one of our state of the art facilities. This exempt position is a crucial part of the service delivery team responsible quality patient care at the health center sites. This position supervises and directs Medical Assistant staff activities to ensure quality of care, patient flow, and compliance with regulations and governing bodies. Additionally, a member of the management team, the Medical Assistant Supervisor evaluates coaches and guides staff performances along with providing indirect and direct patient care within the scope of their respective scope. Responsibilities Summary of Responsibilities: Works closely with the Clinic Manager and other members of the clinic management team to: Maintaining patient flow in clinic to a level that supports agency productivity standards and goals Communicates with appropriate personnel as...

Risk Adjustment Coder I - Sacramento (Central/South) Hybrid 25-234 page is loaded## Risk Adjustment Coder I - Sacramento (Central/South) Hybrid 25-234locations: Sacramento, Californiatime type: Full timeposted on: Posted 4 Days Agojob requisition id: R2344**Were delighted youre considering joining us!**At Hill Physicians Medical Group, were shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.**Join Our Team!**Hill Physicians has much to offer prospective employees. Were regularly recognized as one of the Best Places to Work in the Bay Area and have been recognized as one of the Healthiest Places to Work in the Bay Area. When you join our team, youre making a great choice for your professional career and your personal satisfaction.**DE&I Statement:**At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

Overview We are recruiting for an exciting leadership opportunity as a Medical Assistant Supervisor for experienced or lead MA's at one of our state of the art facilities. This exempt position is a crucial part of the service delivery team responsible quality patient care at the health center sites. This position supervises and directs Medical Assistant staff activities to ensure quality of care, patient flow, and compliance with regulations and governing bodies. Additionally, a member of the management team, the Medical Assistant Supervisor evaluates coaches and guides staff performances along with providing indirect and direct patient care within the scope of their respective scope. Responsibilities Summary of Responsibilities: Works closely with the Clinic Manager and other members of the clinic management team to: Maintaining patient flow in clinic to a level that supports agency productivity standards and goals Communicates with appropriate personnel as...

Location: SF Bay Area, CA (Onsite - 5 days/week) Employment Type: Full-Time, Permanent Compensation: Competitive base salary + annual bonus + full benefits About Us: We are a forward-thinking medical technology and healthcare services organization focused on enhancing patient care through innovative technology-driven programs. Join our team and play an integral role in optimizing reimbursement processes across professional medical billing, payer engagement, and revenue cycle operations. Your Impact: As a Lead Medical Billing Specialist, you will take ownership of essential billing processes, ensuring compliance and efficiency while collaborating with various teams. This role suits detail-oriented professionals who are passionate about driving improvements in healthcare reimbursement. Key Responsibilities: Conduct thorough insurance eligibility and benefits verification through direct payer outreach. Manage the full medical billing lifecycle, encompassing...