36 compliance auditor i jobs found

Job Details Job Location First Internet Bank of Indiana Fishers - Fishers, IN About the Position: As the Small Business Administration (SBA) Compliance Auditor I, you will complete a thorough review of internal, external, and regulatory requirements to ensure compliance with loan program requirements. You will work with the intake and compliance specialists to identify and resolve exceptions. You will also work on loans of a less complex nature, and will work in tandem with the intake and compliance specialists to identify and resolve any known exceptions. What You Will Do: Review newly originated credit facilities for compliance with the SBA SOP 50 10, and any internal or external statutes and guidelines. Maintain adherence to set KPI's and goals revolving around the 60-day review requirement as well as other file intake standards. Review/amend the SBA core system of record to ensure the proper input of the loan's approved structure is reflected. Review...

Introduction OPEN TO ALL QUALIFIED APPLICANTS This is a position specific recruitment. The resulting certified eligible list may be used to staff several current and future vacancies for this position/function only. This recruitment will be closed once all positions have been filled. GRADE 16 (*Please note, state salary guidelines may apply for current state employees) LOCATION OF POSITION Baltimore, Maryland POSITION DUTIES The Comptroller of Maryland's Compliance Division is looking to add new tax auditors to their Business Tax Audit and Individual Tax Audit teams. We offer flexible work schedules that include telework options and opportunities to work from the field (outside of the office) for certain audit assignments. If you're interested in tax auditing and want to join our team, please consider applying. We look forward to meeting you! Business Tax Audit : The main purpose of this position is to audit business entities for compliance with the...

Health Information Management (HIM) Section Position This position is located in the Health Information Management (HIM) section of the Health Administration Service (HAS) at the VA Sierra Nevada Health Care System. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings. Major duties include but are not limited to the following: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding...

Physician Compliance Auditor 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. 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...

Physician Compliance Auditor 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. 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...

Physician Compliance Auditor 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. 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...

Job Details ChristianaCare is searching for a Compliance Auditor to support the Office of Compliance & Privacy through assigned compliance activities and audits to ensure effective clinical documentation that meets regulatory guidelines. The Compliance Auditor performs a variety of audits to investigate and monitor compliance with federal and state laws, as well as Centers for Medicare and Medicaid Services (CMS) regulations, billing, coding and medical necessity documentation guidelines, and HIPAA Privacy standards. They perform financial, operational and compliance audits for the Office of Compliance & Privacy. Work is diverse and assignments could include a wide array of business areas such as inpatient and outpatient services, physician practices, and contracts. An individual with clinical/medical necessity expertise is preferred. The successful candidate must have clinical chart review experience, in addition to broad knowledge of medical claims...

Physician Compliance Auditor 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. 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...

Medical Auditor Hours of Work: Flexible 8 am - 4:30 pm Days Of Week: Monday through Friday Work Shift: Job Description: Remote or On-Site (Dallas, TX) Employment/Education History Requirements: Certifications: High school education or equivalent; some college credit; Bachelor's degree preferred. Certified Professional Coder (CPC) certification from AAPC or Certified Coding Specialist Physician-based (CCS-P) certification from AHIMA with the appropriate level of experience for auditing and abstracting. Preferred: Certified Professional Medical Auditor (CPMA) certification from AAPC Experience/Knowledge: 2+ years of multispecialty auditing medical documentation experience for appropriate E&M level and CPT assignment or 4-5 years of multispecialty coding experience. Thorough knowledge of anatomy/medical terminology. Proficient with Microsoft Word and Excel. Experience with Epic preferred. Ability to communicate effectively via written and verbal communication....

Physician Compliance Auditor 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. 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...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards...

One of our clients in the insurance industry is looking to hire a Field Quality Assurance Compliance Auditor. This is a field-based role supporting audits across Malvern, PA and surrounding areas , with about 70% travel (including some overnight travel). Full-time, Direct hire position We're looking for someone with: A degree in Electrical, Mechanical, Chemical, or Industrial Engineering (or a science-based equivalent) 5+ years in manufacturing and quality auditing Experience with ISO 9001, conformity assessments, and tools like calipers, voltmeters, and pressure gauges Strong communication and analytical skills Certifications like ASQ CQA/CQE or Lead Auditor are a plus! If this sounds like something you would be interested in, please send over a copy of your resume for me to review and I can give you a call to discuss further. Thank you

A healthcare provider in Chicago is seeking a Compliance Auditor to perform audits on provider documentation and coding. Responsibilities include managing compliance issues and communicating effectively with providers regarding results. Candidates should have a Bachelor's Degree and relevant certifications like RHIA or CPC. Strong interpersonal skills and experience in healthcare compliance are preferred. This role offers competitive benefits and opportunities for professional growth. #J-18808-Ljbffr

Job Type Full-time Description Position Summary: The Quality Compliance Auditor will be responsible for performing internal audits, assist with external audits. The Quality Compliance Auditor will also maintain the Quality Management Manual, Procedures and deploys applicable regulations and standards from customers regulatory agencies and OEMs Essential Duties and Responsibilities include the following, other duties may be assigned: Auditing Leads, plans, manages, documents and performs process and product audits internally Facilitates, documents external, regulatory, customer and OEM Audits. Perform reviews and inspections of program artifacts/deliverables and associated activities to assure quality requirements processes and standards are met Initiate and documents internal corrective and preventive actions, evaluate responses and monitor timely resolutions Business Process Management Maintains, develops and publishes all instructions regarding...

A health consortium in Southeast Alaska is seeking a Compliance Auditor. This role involves conducting audits on health records and coding, ensuring compliance with regulations, and preparing reports. The ideal candidate will have a Bachelor's degree in a health-related field, certification as a Professional Coder, and at least three years of relevant experience. The position offers a competitive salary and comprehensive benefits package. #J-18808-Ljbffr

Title : Financial Compliance Auditor III Finance Location : Los Angeles, CA (Hybrid) Employment Type: Contract Compensation Pay Range:$60.00-$66.00 Per Hour Description Responsible for tasks within the Financial Compliance Unit, including financial solvency reviews. Monitor financial solvency compliance for assigned delegates across various lines of business. Work closely with team members on issue resolution. Lead audits independently according to accepted auditing standards and guidelines. Communicate and collaborate on financial solvency issues with stakeholders. Serve as a subject matter expert and mentor for staff. Key Responsibilities Plan, execute, and monitor financial audits and analyses. Ensure compliance with regulatory and contractual requirements. Support the design and implementation of reports and tools for corrective actions. Assess and communicate regulatory requirements impacting processes. Deliver updates and monitor membership...

Primary Job Title: Financial Compliance Auditor III, Claims Location : CA (Hybrid Shift/Work Schedule: Date Posted: 7/10/2025 Employment Type: Contract Salary Range: $50.53 - $55.53/Hr Job Summary The Financial Compliance Auditor III, Claims is responsible for various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans contracted with Client. This role works closely with the Supervisor and/or Lead Auditor on the identification and resolution of issues in a timely and efficient manner. For Claims Emphasis: This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the audit report. This position is responsible for a variety of complex areas of the Medi-Cal, Medicare, Covered California, and PASC-SEIU benefits and processes. This position focuses on audits of contractual and regulatory compliance with timeliness and appropriateness...

Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12483 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims processed by Delegated Participating...

Medical Coder I (On-Site) - Coding Northwest Specialty Hospital is seeking a detail-oriented Medical Coder I to join our Coding Team! We need someone with a professional demeanor, who can work well under stress, provide great customer service, and can multitask! In this role, you will be responsible for assuring that outpatient medical records are coded and abstracted according to established criteria utilizing available resources both automated and manual based on documentation in the medical record provided by the attending, consulting physicians, and clinical information. Duties are accurately performed in completion of, but not limited to, the following areas: use of the available automated systems and the 3M system or other automated systems and enter coded documentation in the medical records on a daily basis. You will stay informed from federal and state organizations to validate the coding process and assure compliance to prevent fraud and abuse related to coding and...

HIM Certified Coder The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications: Education: Highschool Diploma or G.E.D Certifications: Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC); Certified Coding Specialist - Physician-Based (CCS-P) - American Health...

Medical Records - Coder I - Full Time - Days Under the general direction of the Director CDI/Coding or designee, the Medical Records Coder I will improve documentation, data quality and revenue cycle operations. The coder assigns International Classification of Disease system- 10 (ICD), CM, and PCS codes according to AHA AMA Guidelines, CMS and NGS. Core Job Responsibilities Assign diagnosis and procedure codes, for accurate and timely billing of most appropriate payer Audit charges and establish proper coding in collaboration with providers Initiate and follow up on queries with providers Assist departments with diagnostic and procedural coding Respond to Insurance, compliance and RAC denials Review and assist in the maintenance of coding related policies and procedures Perform other duties as required. Education/Experience Requirements Required: AS in Health Information Management, a related degree or equivalent experience Knowledge of EMR, Coding Software,...

Job Description Job Description We're seeking an experienced Inpatient Coder to join our remote Health Information Management team. This advanced coding role functions with a high degree of independence and requires strong analytical skills, coding accuracy, and clinical understanding across a wide variety of specialties. You'll be responsible for accurately assigning ICD-10-CM/PCS diagnosis and procedure codes and MS-DRGs for inpatient hospital services across complex medical and surgical cases. This includes specialties such as Neurology, Oncology, Urology, Transplant, OB/Newborn, Orthopedics, Cardiology, and Critical Care — including trauma and acutely ill patients. This position offers the opportunity to work in a collaborative, quality-driven environment where coders partner closely with Clinical Documentation Improvement (CDI) teams and providers to ensure complete and compliant medical records. Key Responsibilities Assign accurate ICD-10-CM/PCS diagnosis and...

Lead Inpatient Coder At Houston Methodist, the Lead Inpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. Houston...