10 coding documentation compliance auditor jobs found

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...

Ambulatory Procedure Visit-Outpatient Coder All Jobs Company Overview Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently has a contract with the Federal Government. You would be a W-2 employee for HPMG and NOT a government employee. Summary Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for ambulatory procedure visits. Trains and educates MTF staff on coding issues and plays a significant role in departmental and clinic-wide coding compliance activities. Mandatory Knowledge And Skills Position requires excellent computer/communication skills for provider and staff interactions. Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient...

Hospital Billing Specialist Rewarding career. Competitive salary. Outstanding benefits. Standard Expectations: Promotes a Positive Working Environment: Conducts oneself in line with organization's mission, values and standards of behavior. Accepts change and challenges with a positive attitude. Consistently adheres to organizational policy. Communicates Effectively: Builds relationships and works collaboratively with other staff. Provides timely operational updates to supervisor. Responds to communications in a timely manner. Performs Duties Efficiently and Effectively: Follows procedures. Acts in compliance with applicable federal, state, and local regulations. Performs other duties as assigned. Area of Responsibility: Duties & Responsibilities: Hospital Billing & Claims Submission: Prepare, review, and submit hospital (UB-04) claims for inpatient and outpatient services using Epic HB. Ensure claims comply with Critical Access Hospital Medicare billing...

Job Description Job Description Location: Washington State Employment Type: Part-Time Reports To: COO Position Summary The Medical Billing and Coding Specialist is responsible for accurately coding medical services, submitting insurance claims, and ensuring timely reimbursement in compliance with federal regulations, Washington State laws, and payer-specific guidelines. This role plays a critical part in maintaining revenue cycle integrity while supporting compliance with HIPAA and Washington healthcare regulations. Key ResponsibilitiesMedical Coding • Assign accurate ICD-10-CM, CPT, and HCPCS Level II codes to diagnoses, procedures, and services. • Review clinical documentation to ensure coding accuracy and completeness. • Ensure compliance with CMS guidelines, Washington State Medicaid (Apple Health) requirements, and commercial payer policies. • Identify documentation deficiencies and communicate with providers for clarification. Medical Billing • Prepare and submit...

Salary Range $21.47 - $34.31 Overview Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members. Employees of Confluence Health receive a wide range of benefits in addition to compensation. Medical, Dental & Vision Insurance Flexible Spending Accounts & Health Saving Accounts CH Wellness Program Paid Time Off Generous Retirement Plans Life Insurance Long-Term Disability Gym Membership Discount Tuition Reimbursement Employee Assistance Program Adoption Assistance Shift Differential For more information on our Benefits & Perks, click here! Summary Up to $500 in Bonuses! $250 Sign On Bonus and $250 Retention...

Job Summary The Coder's primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record. Job Specific Competencies 1. Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing. a. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy. b. Effectively utilizes coding software and/or books to confirm coding accuracy. c. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. 2. Receives and reviews paper fee slips for hospital...

Description Application deadline: Mar 10, 2026 As a key member of the Amazon One Medical Revenue Cycle team, the Coding Compliance Auditing Manager will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. Demonstrating increased autonomy and strategic thinking and problem-solving skills, this role will lead a team of coding compliance auditors, ensuring accurate medical coding practices, and maintaining compliance with regulatory requirements. This role reports into the Manager III, Revenue Cycle. As someone who naturally enjoys finding ways to improve the status quo, you adeptly identify and create processes necessary to get work done. You comfortably interact with your team members as well as other teams and easily tailor your message and communication style to different audiences. You have a high accountability bar and know how to motivate others, consistently following...

A healthcare organization is hiring a professional to conduct complex audits and assessments of medical records for compliance with state and federal regulations. The ideal candidate should have at least 5 years of experience in medical record documentation review, including knowledge of ICD coding. This full-time role offers a competitive salary range and includes a variety of comprehensive benefits to support employees' wellness and personal development. #J-18808-Ljbffr

Headquarters 600 Orondo Wenatchee, WA 98801, USA Job Summary The Coder’s primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record. Job Specific Competencies Review clinical encounters presented via electronic lists to ensure proper submission of services prior to billing. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy. Effectively utilizes coding software and/or books to confirm coding accuracy. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. Receives and reviews paper...

* Conduct retrospective, concurrent, and prospective audits of medical records to validate the accuracy of ICD-10-CM codes and ensure documentation supports submitted diagnoses for Medicare Risk Adjustment (HCC coding).* Perform detailed internal and external coding audits on a regular basis as defined by compliance & department requirements, including for our nephrology partners.* Execute targeted audit plans, including performing targeted audits of identified HCC outliers.* Identify trends, patterns, and areas of opportunity for documentation and coding improvement through data analysis and audit findings.* Prepare and present formalized audit reports to leadership, summarizing findings, identifying risk areas, and recommending corrective action plans.* Assist in internal and external audits, including Risk Adjustment Data Validation (RADV) audits, by preparing documentation and responding to inquiries.* Perform necessary research to provide supportive regulatory and coding...