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10 coding compliance auditor jobs found

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coding compliance auditor Intermediate Level
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MedKoder
Full Time
 
Physician Coding Auditor
MedKoder Remote
About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health systems, providers, and payers. MedKoder delivers accurate, efficient, and ethical coding, aiming to ensure accurate payment and financial peace for clients. With a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work.   Position Location: 100% Remote This is a full-time, remote position that offers a flexible schedule.  Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable...

Mar 27, 2026
SSM Health
Full Time
 
Coding Educator
SSM Health Remote
Bring your coding expertise to SSM Health in a role where education, quality, and compliance come together. As a Coding Educator, you’ll partner with providers and coders, lead training initiatives, and influence documentation and coding practices that support accuracy, consistency, and revenue integrity across the organization. PRIMARY RESPONSIBILITIES Drives optimal clinical and financial outcomes through thorough assessment of provider documentation and coding competency, identification of improvement opportunities. Develops and delivers training and education of all coding processes. Stays abreast of regulatory changes and works with leadership to ensure compliance and revenue integrity. Act as subject matter expert for providers and coders while providing guidance and clarification on issues which present in their daily account processing. Establishes and coordinates internal quality review processes and corresponding training for providers and coders....

May 27, 2026
Alertive Healthcare Medical Groiup
Full Time
 
Certified Professional Medical Biller & Coder for a Hospitalist Group
Alertive Healthcare Medical Groiup Remote
Position Summary The Certified Medical Biller and Coder is responsible for accurately reviewing medical documentation, assigning appropriate diagnosis and procedure codes, and supporting the billing process to ensure timely and compliant reimbursement. This role plays a critical part in maintaining the integrity of the revenue cycle by ensuring claims are coded correctly, submitted efficiently, and compliant with payer and regulatory guidelines. The position requires strong knowledge of CPT, ICD-10-CM, HCPCS coding systems, payer requirements, and medical billing workflows. Essential Duties and Responsibilities Review provider documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes Ensure coding compliance with Medicare, Medicaid, and commercial payer guidelines Verify documentation supports medical necessity and appropriate coding Apply correct modifiers and place-of-service codes Prepare and review claims prior to submission to ensure...

Mar 09, 2026
New York Oncology Hematology
Full Time
 
Certified Billing and Coding Specialist
New York Oncology Hematology Hybrid (NY)
SCOPE: Under minimal supervision performs periodic, comprehensive coding audits for all assigned regional oncologists (medical, radiation and surgical oncology).   Verifies charge documentation and charge submission processes are in compliance with Federal and State regulations, as well as payer guidelines. Coordinates efforts with manager and front office managers to ensure optimal revenue cycle processes and adherence to compliance and revenue cycle policies and procedures.  Provides effective educational feedback to physicians and staff on findings from audits and updates in Payer billing regulation . ESSENTIAL DUTIES AND RESPONSIBILITIES: Develops Audit and Education Programs Abstracts relevant clinical and demographic information from the medical record to assign current ICD and CPT codes in accordance with coding and reimbursement guidelines. Codes with an accuracy of 97% based on QA internal reviews Performs Evaluation and Management (E&M)...

Mar 02, 2026
SM
Full Time
 
Billing / Coding Compliance Specialist
SIU Medicine Hybrid (Springfield, IL)
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...

May 26, 2026
NC
Full Time
 
Compliance Educator
Nationwide Children's Hospital Columbus, OH
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,...

May 26, 2026
Dana-Farber Cancer Institute
Full Time
 
Billing Compliance Reviewer
Dana-Farber Cancer Institute Remote (Boston, MA)
Billing Compliance Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Overview Reporting to the Director of Billing Compliance, the Billing Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective actions to mitigate compliance risk. The role evaluates the accuracy and integrity of hospital and professional billing practices to ensure compliance with federal and state regulations, payer requirements, national coding guidelines, and internal policies. The Billing Compliance Reviewer is responsible for developing clear findings, collaborating with clinical and administrative stakeholders to resolve issues, and supporting continuous improvement in charge capture, documentation, and coding processes. This role works collaboratively with Coding, HIS, Billing and other internal and external teams to evaluate complex billing issues and initiate...

May 22, 2026
Dana-Farber Cancer Institute
Full Time
 
Senior Billing Compliance Hospital Reviewer
Dana-Farber Cancer Institute Remote (Boston, MA)
Senior Billing Compliance Hospital Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Reporting to the Director of Billing Compliance, the Senior Billing Compliance Reviewer will be responsible for the identification and performance of Billing Compliance inpatient and ambulatory activities. The Senior Reviewer will provide oversight related to reviewing the accuracy and appropriateness of ICD-10-PCS procedure coding and assessing DRG assignment. The Senior Reviewer will assist in the development and execution of the annual Billing Compliance work plan. They will monitor federal and state regulatory requirements and industry developments and work to determine applicability and risk to both technical and operational aspects of the organization. Metrics will be developed and reported quarterly. The Senior Reviewer will be expected to pursue successful completion of multiple tasks collaborating effectively with many departments across the institute, Mass...

May 22, 2026
Brellium
Contract
 
Medical Coder, Behavioral Health (E/M)
Brellium Remote
We are looking for a Medical Coder (Behavioral Health, E/M) to help define how automated and human-in-the-loop coding works at scale. In this role, you will serve as an internal authority on behavioral health E/M coding , partnering closely with Brellium's Customer Success, Product, and Engineering teams. You will help ensure that coding recommendations are accurate, defensible, and aligned with payer expectations — balancing appropriate revenue capture with audit-safe compliance. This is a highly impactful role for an experienced coder who enjoys shaping policy, improving systems, and applying clinical coding expertise in a modern, technology-driven environment. What You'll Do Own Coding Quality & Compliance Review and validate E/M coding for behavioral health encounters in a pre-bill workflow Ensure coding decisions align with documentation, payer guidance, and compliance best practices Define clear standards for when revenue capture is appropriate vs when...

May 22, 2026
Northwest Permanente
Full Time
 
Documentation and Coding Consultant 1
Northwest Permanente Hybrid
Overview: The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations. This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington). Major Responsibilities / Essential Functions: Consulting and Coding services Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions. Within assigned clinical specialties, maintain current knowledge to ensure that KPNW coding and documentation meets regulatory guidelines and audit standards. Follow coding specificity guidelines using coding rules and guidelines. General coding knowledge and understanding of Risk Adjustment models and submission...

May 20, 2026
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