92 coding and compliance auditor jobs found

Job Title Healthcare Compliance Auditor Job Description This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Essential Functions Conduct prospective and retrospective chart reviews comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and recommendations to compliance and...

Integrative Emergency Services, LLC ("IES") is seeking a Coding Specialist with emphasis on auditing surgical services. The Coding Specialist is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects. Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting...

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, 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). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...

Position Description The Documentation and Coding Auditor supports the billing compliance program by helping prevent, detect, and respond to billing, coding, reimbursement, and documentation risks. This role conducts proactive monitoring, auditing, education and risk assessment activities while also responding to identified concerns, audit findings, regulatory changes, and reported compliance issues. Major/Essential Functions Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. Identify and address billing compliance risks before issues escalate by using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce...

Coding Compliance Auditor Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Job Requirements Minimum Education Associates degree in relevant field preferred or combination of equivalent of education and experience Minimum Work Experience Five (5) years coding experience including; but not limited to; hospital inpatient and outpatient encounters Required Licenses/Certifications AHIMA and/or AAPC Coding Credential; CCS preferred Required Skills; Knowledge; and Abilities Ability to consistently and accurately audit coding of inpatient and outpatient encounters Ability to create clear and concise audit reports and maintain productivity standards Must successfully pass pre-hire coding assessment Knowledge of medical...

Job Summary (Par time-Potential for Fulltime) The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations. Key Responsibilities Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes Validate E/M level selection for emergency department visits Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA) Identify under coding, over coding, and documentation deficiencies Prepare detailed audit reports with corrective recommendations Provide education and feedback to coders and providers Train and mentor offshore coding teams on ER coding guidelines and audit findings Conduct regular quality review sessions and calibration meetings with offshore staff Develop and update...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, 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). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, 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). IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition....

Extended Job Title Documentation & Coding Auditor Position Description Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Requisition ID 42210BR Travel Required Up to 25% Pay Grade Maximum Compensation is commensurate upon the qualifications of the individual selected. Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a...

Documentation & Coding Auditor Performs medical billing coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job has no supervisory responsibilities. Travel Required: Up to 25% Pay Basis: Hourly Location: Amarillo Shift: Day Major/Essential Functions Current and active professional medical billing coding certification required from an accredited organization. Billing and coding experience in a multi‑specialty group practice and/or academic practice setting is preferred. Five or more years of health care items/services. Managerial/supervisory and program management implementation experience strongly preferred. Ability to initiate administrative activities as necessary. Excellent oral and written communication skills. Ability to write and present ideas and information in a concise manner. Ability to work collaboratively with all individuals. Professional bearing, sound business judgment...

The Texas Tech University Health Sciences Center is seeking a Documentation & Coding Auditor to conduct medical billing coding and documentation quality audits. In this role, you will provide essential feedback to coding specialists and work collaboratively within the team. This position requires strong problem-solving skills and an active professional coding certification. An ideal candidate will have at least five years of experience in medical billing coding and reimbursement, along with knowledge in CPT, ICD-CM, and related coding systems. You will also be responsible for participating in compliance symposiums and conducting annual risk assessments. #J-18808-Ljbffr

Hendrick Health in Abilene, Texas is seeking a Coding Auditor. The role involves conducting coding compliance audits for inpatient and outpatient encounters and validating coding assignments following established guidelines. Candidates should have an Associate's degree in a relevant field and five years of coding experience. The position requires a strong attention to detail, proficiency in MS Office, and excellent interpersonal skills. A coding certification is preferred. This is an opportunity to work in a supportive environment with a focus on accuracy and productivity. #J-18808-Ljbffr

CVS Health is seeking a Program Integrity Auditor to review medical and behavioral health records to ensure accurate coding and documentation. The role involves audits across Medicaid lines, identifying FWA, and coordinating regulator reporting with a focus on compliance and education for providers. Qualifications include 3–5 years in claims data review and medical records, CPT/HCPCS/ICD-10 proficiency, and an active CPC/CCS/CPMA license. 40-hour workweek and comprehensive benefits offered. #J-18808-Ljbffr

Las Palmas Del Sol Healthcare is seeking an Inpatient Coding Auditor to perform internal quality assessments on coding practices in a work-from-home setting. The role focuses on enhancing the accuracy and integrity of patient data and ensuring coding compliance with various guidelines. The ideal candidate will have strong experience in medical coding and auditing, preferably with at least 3 years in the healthcare field. The position also offers comprehensive benefits, including medical, dental, retirement plans, and educational support opportunities. #J-18808-Ljbffr

## CPC-A Certified Coder RepresentativeApplylocations: San Antonio, Texas, USA - Remotetime type: Full timeposted on: Posted Todaytime left to apply: End Date: August 31, 2026 (30+ days left to apply)job requisition id: R\_2606\_7783**About TaskUs:** TaskUs is a provider of outsourced digital services and next-generation customer experience to fast-growing technology companies, helping its clients represent, protect and grow their brands. Leveraging a cloud-based infrastructure, TaskUs serves clients in the fastest-growing sectors, including social media, e-commerce, gaming, streaming media, food delivery, ride-sharing, HiTech, FinTech, and HealthTech.The People First culture at TaskUs has enabled the company to expand its workforce to approximately 45,000 employees globally. Presently, we have a presence in twenty-three locations across twelve countries, which include the Philippines, India, and the United States.It started with one ridiculously good idea to create a different...

Baylor Scott & White Health in Dallas is seeking a Coding Auditor I to perform coding quality audits, advise coders, and ensure accurate ICD‑10, HCPCS, and CPT coding. This role emphasizes collaboration with Clinical Documentation Specialists to improve documentation quality and compliance. The position requires 5 years of coding experience with at least 1 year as an auditor and certification in RHIA/RHIT/CCS/CCS‑P/CPC/COC/CIC/CIRCC. On-site role with comprehensive benefits plan. #J-18808-Ljbffr

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...

A leading U.S. healthcare company is seeking a Medical Coding Auditor to review medical claims and ensure compliance with coding guidelines. The ideal candidate will have over 3 years of relevant experience and necessary certifications. This remote position offers a competitive salary and benefits, with occasional travel for meetings. Candidates should possess strong attention to detail and the ability to work independently in a production-based environment. Join us in making a difference in healthcare. #J-18808-Ljbffr

Vytwo Technologies Inc. seeks a Risk Adjustment Coding Auditor to perform first and second pass auditing for CMS RADV programs. The role supports a small team with two resources over a 6-month duration, ensuring accuracy and compliance in coding and documentation. The candidate should be a certified risk adjustment coder with CPC and CRC credentials and at least five years of risk adjustment experience. #J-18808-Ljbffr

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. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and physician...

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...

Central Health in Austin, TX is seeking a Healthcare Compliance Coding Auditor to conduct coding audits and communicate results to providers, staff and leadership. The role includes training, reviewing CPT/HCPCS and ICD-10 codes, and updating coding processes annually. Responsibilities include identifying coding discrepancies, guiding improvements, and ensuring compliance with Medicare/Medicaid and private payers. Collaboration across departments and ongoing education are required. #J-18808-Ljbffr

Description Summary: The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with VP/Senior/Manager/Director on...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance with regulatory standards, internal policies and procedures, and other guidelines. Typically reports to Director, Corporate Compliance. Job Description Location : Memorial Hermann, Memorial City Status :...