31 coding compliance auditor jobs found

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records for the Special Investigations Unit (SIU) to ensure coding compliance across medical, behavioral, and other healthcare providers. Responsibilities include comprehensive audits, detailed findings, and clear communication with investigators, regulators and providers. Requires CPC, 3+ years of coding/audit experience, and strong Excel/Word skills. #J-18808-Ljbffr

BJC HealthCare is hiring a Senior Compliance Coordinator who will ensure the accuracy of billing for specialty providers. This remote position involves conducting reviews, preparing reports, and providing education on compliance regulations. The ideal candidate will have 5-10 years of experience and relevant certifications such as CCS/CPC. The role offers the opportunity to develop training material and interact with various departments to support compliance initiatives. #J-18808-Ljbffr

Baylor Scott & White Health in Missouri is seeking a Coding Auditor I to perform coding quality reviews across ICD-10-CM/PCS, HCPCS, CPT and related references. You will collaborate with Clinical Documentation Specialists and coders to ensure accurate and compliant documentation and data abstraction. The role requires strong knowledge of coding rules, HIPAA compliance, and the ability to identify opportunities for improvement. #J-18808-Ljbffr

BJC Medical Group is seeking a Senior Compliance Coordinator to conduct and coordinate reviews of specialty provider documentation to ensure accurate professional billing. You will prepare and present findings to providers and develop educational opportunities on coding and regulatory requirements. You will collaborate with multiple departments to educate staff on compliance and privacy of protected health information and serve as a subject matter expert on specialty coding. #J-18808-Ljbffr

Healthcare Fraud Shield is seeking a Coding Auditor to perform routine coding reviews and ensure medical records align with billed codes. The role requires strong coding knowledge and meticulous attention to accuracy, with supervision by SIU management. The ideal candidate will review claims, abstract codes, and prepare written summaries while maintaining up-to-date knowledge of coding guidelines and privacy standards. The position emphasizes quality, accuracy, and adherence to regulations. #J-18808-Ljbffr

CVS Health is seeking a detail‑oriented medical records auditor/coder to review provider or vendor records and abstract ICD codes for CMS risk adjustment. You will ensure accuracy and full documentation to support clinical narratives. Responsibilities include applying CMS guidelines, verifying medical necessity, and meeting project deadlines in a full‑time setting. Requires CPC/CCS‑P and at least 1 year of related experience. #J-18808-Ljbffr

Healthcare Fraud Shield is seeking a Coding Auditor to perform routine coding reviews and ensure medical records align with billed codes. The role requires strong coding knowledge and meticulous attention to accuracy, with supervision by SIU management. The ideal candidate will review claims, abstract codes, and prepare written summaries while maintaining up-to-date knowledge of coding guidelines and privacy standards. The position emphasizes quality, accuracy, and adherence to regulations. #J-18808-Ljbffr

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...

Job Description The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and...

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of medical records, with focus on identifying and submitting ICD codes for CMS risk adjustment processes. The role emphasizes accuracy, compliance, and timely delivery. The candidate will rely on certified coding credentials and related experience to ensure documentation supports diagnoses and complies with industry guidelines and regulations, in a full-time on-site capacity with comprehensive benefits. #J-18808-Ljbffr

Providence is seeking a Compliance Auditor - Remote to perform audits across the Revenue Cycle, hospital billing, coding, and related controls, ensuring adherence to Federal and State laws, regulations, and Providence policies. Audits are conducted with emphasis on identifying gaps and reducing risk within the system. The role is remote and available to candidates in AK, WA, MT, OR, CA, TX, and NM. A Bachelor's degree in Business/Healthcare/Finance or 5 years of auditing experience is required; #J-18808-Ljbffr

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

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...

Certified Medical Coding Auditor (CPC or CCS-P) Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care Certified Medical Coding Auditor (CPC or CCS-P) 2 weeks ago Be among the first 25 applicants Join to apply for the Certified Medical Coding Auditor (CPC or CCS-P) role at Accelerated Urgent Care About Us Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career...

A leading healthcare provider is seeking a Certified Medical Coding Auditor (CPC or CCS-P) in Bakersfield. This full-time role involves conducting audits, providing regulatory education, and ensuring compliance with billing standards. The ideal candidate will have an active certification, strong communication skills, and at least 3 years of experience. Benefits include medical, dental, vision insurance, and PTO, supporting professional growth within the organization. #J-18808-Ljbffr

West Coast Dental is seeking a full-time Dental Auditor to ensure clinical quality and regulatory compliance in California. The role involves performing audits of dental records, evaluating coding accuracy, and providing feedback to improve documentation quality. The ideal candidate must be a Licensed Dentist in California with strong analytical and communication skills, and familiarity with dental benefit design. Full-time schedule, primarily office-based with occasional travel within the state. #J-18808-Ljbffr

Healthcare Fraud Shield is seeking a Coding Auditor to perform routine coding reviews under the supervision of SIU management. The role focuses on ensuring health records align with billed ICD-10-CM, CPT, HCPCS, and revenue codes with strong attention to detail. The ideal candidate has foundational medical coding knowledge, is familiar with regulatory policies, and comfortable handling confidential information in a remote-friendly environment. #J-18808-Ljbffr

Purpose Statement The Certified Coder will play a key role in converting diagnoses and treatment procedures into ICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. Job Type Full-time Description The Certified Coder will be responsible for coding patient encounters, abstracting diagnostic and procedural information, and ensuring accurate reimbursement based on clinical documentation. Essential Functions Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to Medicare...

Opportunities At Change Healthcare Opportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing Together. Job Description: The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours:...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to Medicare billing, federal...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 59697 -MCS and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to Medicare billing, federal...

Serco Inc. seeks a Medical Coding Auditing Specialist to support the DHA Medical Coding Program Branch (MCPB). You will audit DHA Markets’ MTFs and dental clinics to ensure compliance with coding standards, assist in developing annual audit plans, and perform targeted audits as required. This role involves CONUS/OCONUS travel and onsite visits. The ideal candidate has seven years in medical coding/auditing across multiple specialties, plus professional/institutional coding certifications and #J-18808-Ljbffr