33 coding documentation compliance auditor jobs found

Lead Medical Coder and Auditor ProSidian Consulting is looking for a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

Professional Coding Auditor/Consultant PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA's Revenue Integrity team in a professional coding auditor role. Responsibilities: Responsible for the accurate review of PYA clients' professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education (generally, conducted remotely). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, preferably including...

Job Title Medical Coding Auditor Description This position ensures the accuracy, completeness, and compliance of medical coding and documentation for professional coding services. This role involves reviewing patient records, clinical documentation, and coded data to identify discrepancies and ensure adherence to coding guidelines. By working closely with healthcare providers, coders, and compliance teams, the auditor supports accurate professional coding, optimizing reimbursement, and mitigating compliance risks. Key responsibilities include conducting comprehensive chart reviews, evaluating provider documentation accuracy, and participating in regular audits to maintain high standards of coding accuracy and compliance. The role may involve providing training to healthcare professionals, analyzing coding data, and generating audit reports. Key Responsibilities Audit and Review: Conduct regular audits of medical coding to verify accuracy, completeness, and compliance with...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...

Position Summary The Compliance Auditor will support the compliance functions at SJ/C. The auditor is expected to conduct independent compliance audits and monitor revenue cycle and related processes as identified in the annual compliance plan. Completes audits to ensure revenue cycle and related process compliance with Health System policies, third party payer contracts and government regulations. Prepares detailed reports on audit results and provides education related to billing and coding as well as other compliance requirements. Works with all employees of SJ/C to enhance the efficiency and effectiveness of the billing process at SJ/C and all other SJ/C Affiliates. Education Bachelors - Preferred Completion of relevant continuing education related to recent changes in coding, health care billing, medical terminology and reimbursement - Preferred Experience 3-5 Years combination of school and work experience - Required Recent work experience in...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Work Location: Atlanta, GA Description The Senior Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare...

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

Overview Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. Summary The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal stakeholders...

Join Our Dynamic Revenue Cycle Management Team! West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology, leading physician-led practices offering comprehensive medical and cosmetic dermatology services, are looking for a Senior Medical Biller to join our dedicated Revenue Cycle Management team. As a key player in maintaining the financial health of our practice and supporting high-quality patient care, you'll be working in our established offices located in Carrollton, Newnan, or Peachtree City, GA. Position Overview: The Senior Medical Biller (RCM2) is tasked with efficiently managing billing tasks, resolving claims, and ensuring prompt and accurate reimbursements. This role is perfect for a professional with extensive billing skills who excels in independent work. Your Responsibilities: Claim Management & Payment Posting: Prepare, review, and submit claims accurately and on time; post and reconcile Electronic Remittance Advice...

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Experienced Medical Biller (RCM2) Full-TimeRevenue Cycle Management DepartmentLocations: Carrollton, Newnan, or Peachtree City, GAWork Setting: In-Office) About Our PracticeWest Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology are physician-led, fast-growing dermatology practices serving communities across West Georgia. We provide comprehensive medical, surgical, and cosmetic dermatology services, including in-house Mohs surgery and dermatopathology. Our Revenue Cycle Management (RCM) team plays a vital role in the financial health of the practice and in supporting high-quality patient care. We value accountability, efficiency, teamwork, and continuous improvement. We are seeking an experienced Medical Biller who is confident working independently and ready to take ownership of assigned revenue cycle responsibilities. Position OverviewThe Experienced Medical Biller (RCM2) is responsible for managing assigned billing workqueues, resolving claims efficiently,...

Join Our Dynamic Revenue Cycle Management Team! West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology, leading physician-led practices offering comprehensive medical and cosmetic dermatology services, are looking for a Senior Medical Biller to join our dedicated Revenue Cycle Management team. As a key player in maintaining the financial health of our practice and supporting high-quality patient care, you'll be working in our established offices located in Carrollton, Newnan, or Peachtree City, GA. Position Overview: The Senior Medical Biller (RCM2) is tasked with efficiently managing billing tasks, resolving claims, and ensuring prompt and accurate reimbursements. This role is perfect for a professional with extensive billing skills who excels in independent work. Your Responsibilities: Claim Management & Payment Posting: Prepare, review, and submit claims accurately and on time; post and reconcile Electronic Remittance Advice...

Join Our Dynamic Revenue Cycle Management Team! West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology, leading physician-led practices offering comprehensive medical and cosmetic dermatology services, are looking for a Senior Medical Biller to join our dedicated Revenue Cycle Management team. As a key player in maintaining the financial health of our practice and supporting high-quality patient care, you'll be working in our established offices located in Carrollton, Newnan, or Peachtree City, GA. Position Overview: The Senior Medical Biller (RCM2) is tasked with efficiently managing billing tasks, resolving claims, and ensuring prompt and accurate reimbursements. This role is perfect for a professional with extensive billing skills who excels in independent work. Your Responsibilities: Claim Management & Payment Posting: Prepare, review, and submit claims accurately and on time; post and reconcile Electronic Remittance Advice...

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. 1. Claims Processing: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. 2. Billing and Coding: Ensure that all medical services are accurately coded according to current guidelines (CPT, ICD-10,...

Compliance Audit And Analysis Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers on professional billing and coding. Principal duties and responsibilities: Prepares and oversees professional billing and coding components of the Compliance work plan reflecting scheduled activities and target dates. Leads focused audits and reviews to assess adherence with professional billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. Assists in development of organizational compliance auditing and monitoring activities for professional billing and coding, including periodic reviews of the individual...

Monday–Friday schedule (no weekends) Experienced Medical Biller (RCM2) – Full‑Time Revenue Cycle Management Department Locations: Carrollton, Newnan, or Peachtree City, GA Work Setting: In‑Office About Our Practice West Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology are physician‑led, fast‑growing dermatology practices serving communities across West Georgia. We provide comprehensive medical, surgical, and cosmetic dermatology services, including in‑house Mohs surgery and dermatopathology. Our Revenue Cycle Management (RCM) team plays a vital role in the financial health of the practice and in supporting high‑quality patient care. We value accountability, efficiency, teamwork, and continuous improvement. We are seeking an experienced Medical Biller who is confident working independently and ready to take ownership of assigned revenue cycle responsibilities. Position Overview The Experienced Medical Biller (RCM2) is responsible for managing assigned...

Experienced Medical Biller (RCM2) Full-TimeRevenue Cycle Management DepartmentLocations: Carrollton, Newnan, or Peachtree City, GAWork Setting: In-Office) About Our PracticeWest Georgia Dermatology, Newnan Dermatology, and Peachtree City Dermatology are physician-led, fast-growing dermatology practices serving communities across West Georgia. We provide comprehensive medical, surgical, and cosmetic dermatology services, including in-house Mohs surgery and dermatopathology. Our Revenue Cycle Management (RCM) team plays a vital role in the financial health of the practice and in supporting high-quality patient care. We value accountability, efficiency, teamwork, and continuous improvement. We are seeking an experienced Medical Biller who is confident working independently and ready to take ownership of assigned revenue cycle responsibilities. Position OverviewThe Experienced Medical Biller (RCM2) is responsible for managing assigned billing workqueues, resolving claims efficiently,...

Job Description Job Description The Medical Coder / Coder PAR at Apex Spine and Neurosurgery is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for spine, neurosurgical, and interventional pain management services. This role ensures compliant, complete, and timely coding to support revenue integrity, authorization accuracy, and efficient claims processing in accordance with CMS and payer guidelines. Key Responsibilities Review operative reports, clinic notes, imaging, and diagnostic studies to accurately assign CPT, ICD-10, and HCPCS codes for spine and neurosurgical procedures. Code surgical and procedural services including (but not limited to): spine surgeries, decompressions, fusions, discectomies, laminectomies, injections, nerve blocks, ablations, and other interventional pain procedures. Ensure compliance with CMS guidelines, NCCI edits, payer-specific policies, and internal coding standards. Communicate directly...

Description Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers on professional billing and coding. Principal duties and responsibilities: - Prepares and oversees professional billing and coding components of the Compliance work plan reflecting scheduled activities and target dates. - Leads focused audits and reviews to assess adherence with professional billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. - Assists in development of organizational compliance auditing and monitoring activities for professional billing and coding, including periodic reviews of the individual...

Location: Fully Remote Schedule: Flexible Daytime Hours (Must Work Full-Time) Pay Rate: $35-40/hour Benefits: LaSalle Network contractors have the opportunity to enroll in benefits including medical, dental, and vision insurance. Job Description: My client is hiring for an experienced Inpatient Facility Coder to support hospital-based coding operations within a Trauma Level I teaching facility. This is a fully remote opportunity offering flexible daytime hours, with the expectation that candidates are available to work full-time (40 hours per week). Key Responsibilities: Assign accurate ICD-10-CM and ICD-10-PCS codes for inpatient facility encounters Review clinical documentation to ensure compliant and complete coding Apply inpatient coding guidelines in accordance with CMS, UHDDS, and facility standards Support DRG assignment and coding quality initiatives Collaborate with CDI, physicians, and revenue cycle teams as needed Meet...

Overview Be inspired. Be valued. Belong. At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Individuals with Orthopedic and Neuro surgery experience are encouraged to apply!!! Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and...

Join Datavant, the trusted data collaboration platform for healthcare. Our mission is to make health data secure, accessible, and actionable. We provide vital data solutions for healthcare providers, health plans, researchers, and life sciences companies. From assisting with individual patient requests to advancing AI in healthcare, our team is dedicated to shaping the future of health data. By becoming a Datavanter, you will be part of a dynamic and collaborative team committed to transformative change in the healthcare landscape. What We’re Looking For We are seeking experienced and certified inpatient coders to join our team. The ideal candidate will have exceptional attention to detail and a solid understanding of medical terminology. This fully remote position offers a flexible schedule, allowing you to influence the future of healthcare from wherever you work best! Key Responsibilities: Assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS...