65 coding compliance auditor jobs found

Rush University Medical Center in Chicago, IL seeks a senior coding auditor within the Medical Records department. This role monitors coding quality, provides education to physicians and staff, and prepares reports for administration and the Compliance Council. It requires RHIA/RHIT/CCS certification and 5 years of coding experience, with strong communication skills. The position is full-time, on-site in the Medical Records unit. #J-18808-Ljbffr

The Archdiocese of Chicago is seeking a Compliance Specialist to bridge the Safe Environment Office (OPCY) and parish/school site administrators. You will provide one‑on‑one support, help review OPCY audit submissions, and conduct audits on site or remotely as needed. Responsibilities include organizing data for annual USCCB audits, responding to inquiries, and ensuring compliance with civil reporting requirements. #J-18808-Ljbffr

Serco is seeking a Medical Coding Auditing Specialist to support the Defense Health Agency (DHA) Medical Coding Program Branch. You will conduct routine audits across DHA Markets’ facilities, helping ensure ICD/PCS coding accuracy and compliance with CMS/NCD guidelines. The role involves collaboration on annual audit plans and targeted reviews, with potential CONUS/OCONUS travel, and onsite engagements as needed. #J-18808-Ljbffr

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will ensure coding accuracy, complete documentation, and adherence to state, federal, and company guidelines across medical, behavioral health, and transportation providers. The CPC will audit CPT/HCPCS, discuss findings with Medical Directors, identify billing errors and opportunities for savings, and maintain thorough records while staying current on coding #J-18808-Ljbffr

Huron Consulting Group is seeking a Coding Auditor to join our healthcare-focused team in the United States. You will audit coders, ensure coding accuracy at or above 95%, and perform quality checks on visits coded according to client SOPs. The role requires CPC certification and several years of ambulatory coding auditing experience, with strong analytical skills, attention to detail, and collaboration with HIM and PFS teams to resolve billing issues. #J-18808-Ljbffr

Huron Consulting Group Inc. is seeking a skilled analyst to conduct coding audits and ensure accuracy across ambulatory coding practices. You will work with coders and auditors, perform quality checks, and contribute to improving revenue cycle outcomes. The role requires CPC certification, experience with encoder tools, and strong analytical and communication skills to support leadership and clients in a fast-paced healthcare environment. #J-18808-Ljbffr

Huron is seeking a Coding Auditor for ambulatory/professional coding auditing to ensure accuracy standards across client teams and payers. The role involves auditing coders and auditors, reviewing documentation, and communicating findings by phone, email, and instant messaging. It reports to Huron Managed Services Domestic Coding team and requires 95%+ accuracy and collaboration with HIM and PFS teams. #J-18808-Ljbffr

Pediatric Coding Auditor Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. Job Description Summary: Conducts retrospective audit of ambulatory and inpatient physician documentation to ensure billing accuracy and compliance. Accounts for concurrent inpatient billing accuracy and compliance for selected Divisions. Provides physician education on coding and documentation guidelines. Essential Job Functions: Reviews and audits physicians' documentation in the medical record and the level of CPT code selection to verify accuracy through a concurrent coding...

Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote) At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As part of our team, you’ll have the opportunity to contribute to better health care across the Northwestern Medicine system. We offer competitive benefits including tuition reimbursement and loan forgiveness, 401(k) matching, and lifecycle benefits. The Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and regulatory standards. This role is the expert in clinical documentation and coding, working with the Clinical Documentation Team to ensure quality metrics meet high standards for NM Health System. The Coding Quality Auditor and...

Inpatient Coding Auditor Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the...

The Inpatient Coding Auditor will be responsible for auditing inpatient coders and offshore inpatient coding auditors to ensure coding accuracy and DRG accuracy of a minimum of 95%. The role requires frequent and effective communication via phone, email, and instant messaging with various client teams and payers. The Inpatient Coding Auditor reports to the Huron Managed Services Domestic Coding team. Key Responsibilities Audit inpatient coders and auditors to ensure compliance with client SOPs and coding guidelines. Perform quality checks, calibration audits, and suggest improvements. Conduct calibration sessions with offshore team counterparts and leaders. Prepare audit reports and provide direct feedback to coders and auditors on areas of opportunity. Participate in client interactions and internal stakeholder meetings. Monitor coding guideline compliance and correct identified errors before claims are rebilled. Conduct analysis and present summaries of findings to leadership in...

Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: PB Revenue Integrity Work Type: Full Time (Total FTE 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $32.00 - $52.08 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient encounters to ensure coding...

Key Responsibilities Integrate Huron’s Vision and Values into daily work practices. Conduct audits of coders and auditors, ensuring a minimum coding accuracy of 95%. Perform quality checks on visits coded per client SOPs and conduct calibration audits. Suggest process improvements and schedule calibration sessions with offshore team counterparts and leaders. Assist in preparing audit reports, provide direct feedback to coders and auditors, and participate in client and internal stakeholder meetings. Monitor compliance with clinical documentation and coding guidelines; ensure errors are corrected before claims are rebilled to payers. Analyze findings and present concise, actionable summaries to leadership. Utilize encoder software applications (3M/Solventum, Encoder Pro, Codify) and assign appropriate codes using CDC, CMS, AMA, AHA, AMA CPT, and other guidelines. Navigate patient health records and other systems to determine accurate diagnosis and procedure codes. Meet coding...

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...

CVS Health is seeking a Medical Records Auditor to audit and abstract medical records for CMS risk adjustment, ensuring accurate ICD coding and documentation compliance. You will support coding judgments with industry standards and maintain strict timelines across provider and vendor records. The role requires 1 year of related experience and CPC/CCS-P credentials, with AA/AS or equivalent preferred and CPC/CCS-P training completion viewed favorably. #J-18808-Ljbffr

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

A healthcare consulting firm in Chicago seeks an Inpatient Coding Auditor to perform coding audits and ensure compliance with accuracy standards. Applicants should have 2+ years as a coding auditor, current U.S. work authorization, and experience with various coding guidelines. This role requires strong analytical and communication skills, alongside proficiency in Microsoft Office. The position offers a salary range of $26.44 – $36.06 per hour. #J-18808-Ljbffr

The Coding Auditor – ambulatory/professional coding/profee will be responsible for auditing coders and coding auditors to ensure coding accuracy standards are met. The role requires frequent and effective communication via phone, email, and instant messaging with various client teams and payers. The Coding Auditor will report to the Huron Managed Services Domestic Coding team. Key Responsibilities Demonstrates Huron’s Vision and Values in all behaviors. Functions as Coding Auditor Ensure coding accuracy of ≥95% through audit of coders and auditors. Perform quality checks and calibration audits on visits coded per client SOP. Suggest improvements, schedule calibration sessions with offshore counterparts and leaders. Assist in preparing audit reports and provide direct feedback to coders and auditors. Firm understanding of clinical documentation guidelines. Monitor compliance of coding guidelines and correct identified errors before claims rebill. Conduct analysis and...

Key Responsibilities Integrate Huron’s Vision and Values into daily work practices. Conduct audits of coders and auditors, ensuring a minimum coding accuracy of 95%. Perform quality checks on visits coded per client SOPs and conduct calibration audits. Suggest process improvements and schedule calibration sessions with offshore team counterparts and leaders. Assist in preparing audit reports, provide direct feedback to coders and auditors, and participate in client and internal stakeholder meetings. Monitor compliance with clinical documentation and coding guidelines; ensure errors are corrected before claims are rebilled to payers. Analyze findings and present concise, actionable summaries to leadership. Utilize encoder software applications (3M/Solventum, Encoder Pro, Codify) and assign appropriate codes using CDC, CMS, AMA, AHA, AMA CPT, and other guidelines. Navigate patient health records and other systems to determine accurate diagnosis and procedure codes. Meet coding...

Overview The Coding Auditor – Ambulatory/Professional Coding is responsible for auditing coders and coding auditors to ensure that coding accuracy meets a minimum of 95%. This role reports to the Huron Managed Services Domestic Coding team and requires frequent communication with client teams and payers via phone, email, and instant messaging. Key Responsibilities Demonstrate Huron’s vision, values, and professional standards in all activities. Audit coders and auditors to ensure coding accuracy of at least 95%. Perform quality checks and audits on visits coded per client SOPs. Conduct calibration audits and schedule calibration sessions with offshore team counterparts and leaders. Assist in preparing audit reports, provide direct feedback to coders and auditors on areas of opportunity, and participate in client interactions and internal stakeholder meetings. Maintain a firm understanding of clinical documentation guidelines and monitor compliance of coding guidelines. Identify and...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long‑term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. As an Inpatient Coding Auditor, you will audit inpatient coders and offshore inpatient coding auditors to...

A leading healthcare institution in Chicago is seeking a Billing Coding Auditor to ensure accuracy in coding and documentation. The role involves troubleshooting patient accounts, collaborating with various departments, and maintaining compliance with billing guidelines. Ideal candidates will have healthcare experience and relevant coding certifications. The position offers a full-time work schedule with a competitive salary range of $29.36 - $47.79 per hour, based on experience and qualifications. #J-18808-Ljbffr

Job Description Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: PB Revenue Integrity Work Type: Full Time (Total FTE 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $32.00 - $52.08 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient encounters to...