1200 compliance coding auditor jobs found

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

City/State Norfolk, VA Work Shift First (Days) Overview: Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding...

Compliance Coding Auditor page is loaded## Compliance Coding Auditorremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR-99531**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology,...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report...

OverviewThis position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff.This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis.ResponsibilitiesEssential Duties :Conduct prospective and retrospective chart reviews (i.e.baseline, routine periodic, monitoring, and focused) comparing medical and / or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer / title / grant coding requirements.Identify coding discrepancies and formulate suggestions for improvement.Communicate audit results / findings to providers and / or ancillary staff and share improvement ideas.Work with the Office of the CMO and provider leadership to identify and assist providers with coding.Report findings and recommendations to Compliance...

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical and/or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer/title/grant coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with the Office of the CMO and provider leadership to identify and assist providers with coding. Report findings and recommendations to Compliance...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...

Coding & Documentation Compliance Auditor Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: Conducts audits in accordance with the approved Revenue Compliance Work Plan...

Professional Credit Service is hiring an experienced Inpatient Medical Coding Auditor to perform audits of acute inpatient medical records. This role ensures coding accuracy and compliance with coding guidelines, while providing feedback and insights to improve documentation practices. Ideal candidates will possess active AHIMA or AAPC certification and have 3-5 years of auditing experience. This full-time position offers remote work, competitive pay, and excellent benefits including health insurance and a 401k plan. #J-18808-Ljbffr

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines; possesses substantial knowledge of...

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

A healthcare service organization is seeking a Medical Coding and Billing Compliance Auditor to perform coding audits and ensure compliance with regulations. The role requires extensive coding knowledge, analytical skills, and a strong background in Microsoft Office applications. Applicants should have a current coding credential and a minimum of three years of outpatient coding experience. This is a full-time remote position. #J-18808-Ljbffr

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

Presbyterian Healthcare Services is hiring a Profee Remote Auditor/Educator to join their team. This full-time role, based remotely in New Mexico, involves supporting coding and documentation quality assurance while ensuring compliance with regulatory standards. Responsibilities include conducting audits, training staff, and managing documentation. Candidates should have a high school diploma or GED, relevant licenses, and at least 3 years of coding and auditing experience. The position offers a comprehensive benefits package including medical, dental, and vision coverage. #J-18808-Ljbffr

Coding & Documentation Compliance Auditor Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: Conducts audits in accordance with the approved Revenue Compliance Work...

Job Summary: Assists with implementing and maintaining a system-wide effective compliance program through performance of compliance and coding quality audits. Under indirect supervision, assures appropriateness and accurate coding assignments in accordance with federal coding regulations and guidelines. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional and facility fee documentation, coding and billing, including CMS and OIG compliance standards. Leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Prepares written reports of findings. Also responsible for providing assistance with coding inquiries from providers, coders, billing staff, etc. Monitors relevant resources and publications related to high-risk compliance areas. Serves as an audit software system administrator as assigned....

Professional Credit Service is hiring an experienced Inpatient Medical Coding Auditor to perform audits of acute inpatient medical records. This role ensures coding accuracy and compliance with coding guidelines, while providing feedback and insights to improve documentation practices. Ideal candidates will possess active AHIMA or AAPC certification and have 3-5 years of auditing experience. This full-time position offers remote work, competitive pay, and excellent benefits including health insurance and a 401k plan. #J-18808-Ljbffr

A healthcare organization based in Austin, Texas is seeking a Coding Auditor to conduct coding audits, ensure compliance with medical billing guidelines, and provide training for providers and staff. The ideal candidate should have a minimum of 5 years of healthcare experience and 4 years of coding experience. Relevant certifications are required. This position plays a crucial role in supporting the implementation of coding changes and improving accuracy across the organization. #J-18808-Ljbffr

Where You'll Work CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence. Job Summary and Responsibilities The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an emphasis on documentation, coding improvement, and revenue capture. Provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, classroom settings, webinars, and...

Coding Compliance Auditor Fully Remote Overview Position Type Full Time Education Level High School Diploma/GED Category Other Positions Description US Heart and Vascular is in need of a Remote Coding Compliance Auditor to join our team. The Coding Compliance Auditor performs internal medical record audits and prepares compliance auditing reports, subsequent educational materials and training as directed by the Compliance and Privacy department. Audits include regular compliance medical record audits or focused review projects for ongoing review of coding and documentation for cardiovascular specialties to support compliance with coding and documentation rules and regulations. Responsibilities: Performs coding audits reviewing for compliance and accuracy with CPT, ICD-10, HCPCS and corporate coding policy and follows up for timely completion within designated time period. Maintains excellent documentation of all reviews, methodologies employed, results,...

To support the Revenue Cycle team, the part-time Certified Coding Compliance Auditor will conduct audits of medical coding practices, ensuring accuracy and compliance with regulatory requirements while collaborating with clinical and revenue cycle teams in a remote setting. Key responsibilities Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes Review documentation to ensure appropriate code assignment and adherence to medical necessity requirements Track and report coding errors, maintaining detailed records of audit findings Required qualifications Associate's degree in a related field 3+ years of coding/auditing experience in professional fee and/or risk adjustment settings Knowledge of industry standard code sets and guidelines (ICD-10-CM, CPT, HCPCS) CPC certification through AAPC and/or CCS certification through AHIMA required CPMA and CRC certification through AAPC required

To support the Amazon One Medical Revenue Cycle team, the full-time Coding Compliance Auditor will conduct audits of medical coding practices, ensuring compliance with regulatory requirements and organizational policies while working remotely. Key responsibilities Conduct regular audits to verify the accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes Review documentation to ensure appropriate code assignment and adherence to medical necessity requirements Track and report coding errors and findings, maintaining detailed records of audit results Required qualifications Associate's degree in a related field 3+ years of coding/auditing experience in professional fee and/or risk adjustment settings Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS) CPC certification through AAPC and/or CCS certification through AHIMA required CPMA and CRC certification through AAPC required

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive...

US Heart & Vascular is seeking a Remote Coding Compliance Auditor to perform internal medical record audits and prepare compliance reports. The role involves evaluating coding accuracy and maintaining documentation of all audits to support compliance regulations. The ideal candidate should have at least 5 years of medical coding experience and necessary certifications, along with strong communication and analytical skills. This position is critical in ensuring adherence to coding and documentation standards. #J-18808-Ljbffr