6 coding documentation compliance auditor jobs found

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...

Job Description Job Description Warm Valley Health Care is looking to add to the Billing/Coding department. Job Summary: The Medical Biller/Coder is responsible for translating healthcare services rendered into standardized codes for insurance billing, ensuring accurate reimbursement. This role ensures the efficient processing of patient data, medical records, and insurance claims in compliance with healthcare regulations. Key Responsibilities: Accurately assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses and procedures based on medical documentation. Review patient records for completeness, accuracy, and compliance with regulations. Prepare and submit clean claims to insurance companies electronically or via paper submission. Follow up on unpaid claims within standard billing cycle timeframe. Resolve billing issues with insurance companies, patients, and healthcare providers. Correct rejected or denied claims and resubmit for payment. Post payments and...

Basic Function HF Sinclair Midstream is seeking a Compliance Auditor Lead. The position is open to Dallas, TX; Tulsa, OK; Artesia, NM or Salt Lake City, UT. The Compliance Auditor Lead ensures compliance with regulations and conducts moderate to complex regulatory compliance and auditing assignments for assigned areas under general supervision. Job Duties Reviews, interprets, and ensures compliance with applicable federal, state, and local regulatory requirements for all assigned locations. Plans, conducts, and leads regulatory compliance and operational risk‑based audits, including evaluations and review of internal policies and procedures of the company operations. Serves as the primary liaison to regulatory agencies and as the Company's point of contact for general inquiries, audits, and on‑site evaluations. Leads and coordinates follow‑up activities associated with regulatory inspections, audits, and enforcement actions by tracking corrective actions, conducting gap...

Serco is seeking a Medical Coding Auditing Specialist to support the Defense Health Agency's Medical Coding Program Branch. The role focuses on audits to validate ICD, CPT, HCPCS coding accuracy within 400 DHA facilities, with potential CONUS/OCONUS travel. Responsibilities include planning audits, providing conduit to the DHA-MCPB, and ensuring compliance with coding policies and regulations, including CMS guidance. Documentation of education is required. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Certified Medical Coding Specialist Sublette County Health Discover Your Next Adventure in Pinedale, Wyoming! Nestled in the heart of the breathtaking Wind River Range, Sublette County offers the rugged beauty of the West alongside a once-in-a-lifetime career opportunity. Sublette County Health proudly operates two urgent care clinics with Level 5 Trauma receiving Emergency Rooms, as well as two EMS stations. On August 4, 2025, we opened Sublette County’s first hospital – a historic milestone for our community. As part of our growth, Heritage Home – our Skilled Nursing facility – is expanding to its new home with a 40‑bed Skilled Nursing Unit and a brand‑new 10‑bed Memory Care Unit, designed to provide compassionate, resident‑centered care. Overview The Certified Medical Coding Specialist translates clinical and/or ambulance work into code and enters billing codes into the practice management system for reimbursement. The role also performs chart compliance audits and provides...