6 certified coder auditing jobs found

Rocky Mountain Review brings clarity and confidence to healthcare by focusing on what matters most—accuracy, accountability, and the people behind every claim.   In an industry often driven by speed and volume, Rocky Mountain Review stands for thoughtful review and sound judgment. Our approach is rooted in a simple belief: every decision should be defensible, every outcome intentional, and every client supported with consistency they can rely on.   We engage deeply across the claim lifecycle—strengthening payment integrity, supporting plan performance, and delivering insights that empower better decisions. By combining clinical expertise with meticulous review processes, we ensure that nothing is overlooked, and everything is aligned, every time.   About This Opportunity:   As a Lead Coding, Audit, and Compliance Specialist, you play a critical role in ensuring accuracy and integrity across...

CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Overview Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding operations by...

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute Boston, MA Full Time The Billing Compliance Curriculum Development Specialist is responsible for the design, development, implementation, and evaluation of enterprise-wide billing compliance education programs at Dana-Farber Cancer Institute (DFCI). This role serves as a subject-matter expert in professional and technical billing compliance, with a strong emphasis on oncology services, regulatory requirements, and risk-based education strategies. The position partners closely with Billing Compliance leadership, Revenue Cycle, HIM, Clinical Operations, and Compliance to ensure education is standardized, scalable, evidence-based, and aligned with CMS, OIG, NCCI, payer guidance, and institutional risk priorities. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united...

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program.  The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Job Summary Designs and delivers education programs on compliant documentation, coding and billing practices, regulatory requirements, and internal policies through learning experiences such as instructor-led sessions, webinars, and e-learning modules. Serves as a key resource for physicians, clinical staff, auditors, coders, and other stakeholders, ensuring understanding and adherence to applicable standards. Analyzes data and reports to identify educational needs and may conduct limited audits to support targeted training efforts. Essential Functions: Develops and delivers targeted education based on new service or program implementation, CPT/ICD-10 changes, and regulatory changes. Reviews audit data and compliance trends to identify educational gaps and address areas of risk. Designs and maintains educational content and resources, supporting accurate CPT and diagnosis coding for professional services,...