48 coding and compliance auditor jobs found

Covenant Health in Knoxville, TN seeks a Compliance Auditor Sr. who will lead complex internal auditing efforts, ensuring compliance with billing and coding regulations. You will evaluate risk areas and document audit findings while mentoring department staff. A successful candidate will have a deep understanding of healthcare billing, at least five years of experience in the healthcare sector, and relevant certifications. The position demands skills in problem-solving and public relations in a fast-paced environment. #J-18808-Ljbffr

Overview Coding Educator, C linical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift This is a hybrid position, with onsite requirements for education Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Provides consulting services to the organization’s management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders,...

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

Overview Compliance Auditor Sr. Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: Performs complex-level professional internal auditing. Work involves leading or conducting compliance audit projects for Covenant Health entities as they relate to charging, coding, documentation and billing compliance....

Covenant Health in Knoxville, TN is looking for a Compliance Auditor to perform internal audits and ensure compliance with coding and billing regulations. The ideal candidate will have 3-5 years of healthcare experience, expertise in billing compliance, and possess the necessary certifications like RHIT or RN License. Employment offers a full-time role with a day shift schedule and competitive pay. #J-18808-Ljbffr

Overview Compliance Auditor Full Time, 80 Per Hour Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee’s top-performing healthcare network with 10hospitals and over 85outpatient and specialtyservices,andCovenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned, not-for-profit healthcare system and the area’s largest employer with over 11,000 employees. Covenant Health is the only healthcare system in East Tennessee to be named six times by Forbes as a Best Employer. Position Summary: Performs complex professional internal auditing. Work involves compliance audit projects for Covenant Health entities as they relate to charging, coding, documentation and billing compliance. Also provides consulting services to the organization’s management and staff and may participate in requested investigations. Maintains all organizational and professional ethical standards....

Covenant Health in East Tennessee is seeking a qualified internal auditor to perform complex compliance audits across charging, coding, documentation and billing processes within our system. The role reports to the Compliance Audit Manager and works with physicians, clinical management, and staff to mitigate risk. The successful candidate will review Medicare/Medicaid guidelines, stay current on payer rules, and coordinate with various departments to resolve overpayments, document findings, and #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community 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. Where you Come In 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 of...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Imagine Pediatrics is looking for a Coding Compliance Auditor in Nashville, TN. This role involves ensuring accurate coding while collaborating with clinical and compliance teams. Responsibilities include reviewing medical records, conducting audits, and preparing reports. The ideal candidate has over 5 years of experience in fee coding and auditing, with a strong understanding of HEDIS measures. A bachelor’s degree in healthcare management is preferred, and familiarity with EMR software is essential. #J-18808-Ljbffr

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Auditor Job Summary and Qualifications The Coding Auditor is responsible for performing quality reviews and audits of the assigned staff. This includes coordination with the department managers to ensure standards are met in accordance with department and organization policy. Additionally, this team member contributes to improving the processes and infrastructure of the department. Proficient in facilitation and interpersonal communication, this team member also consistently demonstrates skills in organization, prioritization, professionalism and coaching others. What you will do in this role: Perform regularly-scheduled quality reviews...

Become a part of our caring community 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 direction and receives guidance where needed....

HCA Healthcare is seeking a work-from-home Inpatient Coding Auditor responsible for performing internal quality assessments of coding staff to ensure compliance with national coding guidelines and company policies. The role requires strong coding knowledge and a commitment to maintain high productivity and accuracy standards. HCA Healthcare offers a comprehensive benefits package that includes medical, dental, vision, and education support, ensuring a well-rounded employee experience. #J-18808-Ljbffr

Cognizant is seeking an Inpatient Medical Coding Auditor to review inpatient records for accuracy and compliance, provide guidance on ICD-10 coding, and support client health information management teams. The role requires AHIMA certifications, extensive facility auditing experience, and the ability to work independently within a remote U.S. team. Competitive compensation and benefits are offered. #J-18808-Ljbffr

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Coding Educator, Clinical Document Integrity This is a hybrid position, with onsite requirements for education. Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Provides consulting services to the organization's management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician office staff. Serves as a resource to coders,...

Overview Coding Specialist, Centralized Coding, Inpatient Coder Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: This individual provides leadership, direction, and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Summary Outpatient/Inpatient (Coder) select codes from current versions of ICD CM, PCS classification systems for inpatient facility and/or professional services. Inpatient duties consist of the performance and review of documentation within the health record to assign ICD codes for diagnosis, complications/major complications, comorbid/major comorbid conditions, surgery, and procedures for assignment of diagnosis related groups (DRG),and/or assigning CPT/HCPCS codes. Responsibilities This job opportunity announcement (JOA) will be used to fill 1 full-time and permanent Medical Records Technician (Outpatient/Inpatient Coder) vacancy(s) at the Memphis, TN Veteran Affairs Medical Center (VAMC), with Business Office Service. The technician is assigned to the Health Information Management Section (HIMS), coding/analysis unit, VAMC Memphis, TN. Outpatient/Inpatient MRTs(Coder) select and assign codes from current versions of ICD CM, PCS, and/or CPT and HCPCS classification systems for...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...