2 coding documentation compliance auditor jobs found

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,...

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...