70 coding compliance auditor jobs found

Job Description Align 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 paid vacation, wellness initiatives and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What you be doing in this role: The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with providers and staff to educate and train or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with...

A renowned healthcare institution is seeking a Coding Compliance Auditor to conduct audits and ensure adherence to federal coding regulations. This full-time role entails performing internal audits, supervising coding accuracy, and communicating effectively with staff. Candidates must possess relevant certifications and at least five years of experience in coding. The expected salary range is $33.00 - $54.02 per hour. #J-18808-Ljbffr

A leading educational institution seeks a Coding Compliance Auditor to perform audits, ensure accurate coding, and facilitate compliance with regulations. The ideal candidate should have a minimum of 5 years experience in ICD-9 & ICD-10 coding, possess a CPC or CCS-P certification, and demonstrate strong communication skills. This position involves mentorship, audit reporting, and collaboration with diverse healthcare professionals. Competitive hourly rate ranging from $33 to $54.02 per hour is offered, based on experience and qualifications. #J-18808-Ljbffr

Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations. Key Responsibilities: Conduct thorough reviews of medical records for compliance with coding regulations Provide feedback and education to coders and physicians to improve coding accuracy and documentation Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries Support ongoing program development through training initiatives and process improvements Deliver coding presentations to diverse audiences, including physicians May supervise departmental staff as needed Qualifications: Minimum of...

A healthcare provider in San Diego seeks a Compliance Coding Auditor to oversee compliance audits related to coding and billing practices. The role involves ensuring adherence to regulations, conducting audits, and providing reports to improve compliance within the organization. A Bachelor's degree and relevant experience in coding are required. Certification in clinical documentation improvement is preferred. The position also demands excellent communication skills and the ability to function in a fast-paced environment. #J-18808-Ljbffr

A healthcare provider in San Diego is seeking a Coding Auditor to conduct audits and ensure compliance with coding standards. The role requires strong knowledge of CPT and ICD-10 codes, exceptional communication skills, and the ability to train clinical staff. The ideal candidate has 3 years of experience in a healthcare setting and holds a CPC or CCS-P certification. Competitive hourly rate offered. #J-18808-Ljbffr

Compliance Coding Auditor The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in oversight of Sharp HealthCare's (SHC) compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits. Required Qualifications: 5 Years experience in acute care inpatient/outpatient coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. Preferred Qualifications: Strong...

A healthcare organization based in Los Angeles seeks a Coding Auditor to conduct comprehensive reviews of medical documentation and billing processes. You will manage AI-generated coding recommendations for compliance and revenue integrity, ensuring accurate assignment of coding standards. Collaboration with team members and dedication to the organization's mission are crucial. Ideal candidates should have strong skills in ICD-10 and CPT coding. A comprehensive benefits package is offered alongside this role. #J-18808-Ljbffr

Facility: System Services City San Diego Department Job Status Regular Shift Day FTE 1 Shift Start Time Shift End Time Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate; Other; Certified Health Care Compliance (CHC) - Compliance Certification Board Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $49.700 - $64.130 - $71.820 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

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 Records Technician (Coder) Auditor (Inpatient) The Medical Records Technician (Coder) Auditor serves in the Health Information Management Section of Health Administration Service in the VA Long Beach Healthcare System (VALBHCS). This position is located in the Health Information Management (HIM) section. Regarding remote work status, please read the duties section of this announcement. This position is designated as remote. Remote work is defined as full-time employment conducted outside of a VA facility or in VA-leased spaces. The option for remote work will be assessed continuously, and the selected individual may need to return to a VA office if required. Any selected candidate must live within 50 miles of a VA Medical Center. Duties include, but are not limited to: Ability to work with a team to provide technical guidance, plan, organize, and coordinate activities in order to effectively complete job duties of assignment, such as distributing workload, monitoring...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

divh2AIDS Healthcare Foundation/h2pstrongAMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!/strong/ppDoes the idea of doing something that really makes a difference in peoples lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?/ppstrongIf so, AIDS Healthcare Foundation is the place for you!/strong/ppFounded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them./ppAHFs core values are to be:/pulliPatient-Centered/liliValue Employees/liliRespect for Diversity/liliNimble/liliFight for Whats Right/li/ulpPlease review our Advocacy page for...

Become a part of our caring community and help us put health first 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. 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...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

Overview Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qualified Health Center (FQHC), we provide vital health services to almost 40,000 individuals annually in Marin County. The Clinics regularly receive national awards from the Health Resources and Services Administrations (HRSA). Our Mission is to promote health and wellness through excellent, compassionate care for all. The Compliance Auditor supports Marin Community Clinics’ compliance, risk management, and quality programs by performing independent audits, monitoring activities, and data validation to ensure adherence to federal and state regulations. This includes HRSA Health Center Program requirements, FTCA, CMS billing and documentation rules, Medi-Cal, TJC standards, HIPAA/HITECH, 42 CFR Part 2, California health laws, and internal policies. The role works closely with clinical,...

WHO WE ARE AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are to be: Patient-Centered Value Employees Respect for Diversity Nimble Fight for What’s Right Please review our Advocacy page for the latest news on how AHF is Fighting for What’s Right! Advocacy News....

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

Overview Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qualified Health Center (FQHC), we provide vital health services to almost 40,000 individuals annually in Marin County. The Clinics regularly receive national awards from the Health Resources and Services Administrations (HRSA). Our Mission is to promote health and wellness through excellent, compassionate care for all. The Compliance Auditor supports Marin Community Clinics’ compliance, risk management, and quality programs by performing independent audits, monitoring activities, and data validation to ensure adherence to federal and state regulations. This includes HRSA Health Center Program requirements, FTCA, CMS billing and documentation rules, Medi-Cal, TJC standards, HIPAA/HITECH, 42 CFR Part 2, California health laws, and internal policies. The role works closely with...

Job Description Shared Services: Compliance- (Full-Time, Day Shift) - Job Summary: The Compliance Auditor-Physician monitors and audits established mechanisms and controls to ensure compliance with regulations. Audits the activities of various departments for compliance with plans, policies and procedures prescribed by management. Prepares and submits reports on the results of audits, recommending improvements in policies and procedures. Cooperates with outside auditors in any undertaking that may expedite their work. Performs other duties as needed. Conducts full range of physician-based audits/projects and develops partnerships with internal and external customers. Performs other duties as needed. Education and Experience: Bachelor's Degree required. Master's Degree preferred. Minimum three years of experience in auditing within healthcare, compliance, regulatory oversight agency, quality management, quality assurance or business analysis. Knowledge and Skills:...

A healthcare firm supporting agriculture seeks a Claims Auditor for remote work, ensuring compliance with health benefits plans. The role involves coding new business, verifying plans, and maintaining efficiency in processes. Candidates should have a BS/BA degree and at least two years in claims auditing. The position offers a salary range of $46,669.19 - $65,668.50 and a benefits package including profit-sharing. #J-18808-Ljbffr