60 compliance coding auditor jobs found

Compliance Coding Auditor-EducatorTrinity Health IHA Medical Group is looking for a customer-focused Compliance Coding Auditor-Educator to join our team. In this role, you will serve as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding.What You'll Do:Develops and leads audit projects for medical record integrity.Reports audit results utilizing a standard reporting process.Identifies new errors while performing audits, investigates and assesses root cause.Performs one-on-one Audit meetings and provides for corrective educational guidance.Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelinesProvides training for IHA staff and providers on CPT, ICD10 and HCC coding standards and procedures.General Requirements:EDUCATION: Bachelor's degree or...

Trinity Health IHA Medical Group is seeking a Compliance Coding Auditor-Educator to serve as the subject matter expert for CPT, ICD and HCC coding across IHA offices. You will lead audits, report results, and provide corrective educational guidance to staff and providers. The role requires a bachelor’s degree and coding credentials (CPC or RHIT), with at least two years of experience in coding, reimbursement analysis, and medical record auditing. #J-18808-Ljbffr

Trinity Health IHA Medical Group is seeking a Compliance Coding Auditor-Educator to serve as the subject matter expert for CPT, ICD and HCC coding and to be a key contact for IHA offices and the Revenue Department. You will develop and lead audit projects, report results through a standard process, identify errors, conduct one‑on‑one audit meetings, and provide corrective education. You will train staff and providers on coding standards to support accurate, compliant medical documentation. #J-18808-Ljbffr

Emory Healthcare is seeking a remote Medical Coding Auditor to ensure the accuracy, completeness, and compliance of professional coding and clinical documentation. You will review patient records and collaborate with providers, coding teams, and compliance staff to support accurate coding and appropriate reimbursement. The role emphasizes audits, ongoing education on ICD-10, CPT, HCPCS, HIPAA, and regulatory standards. #J-18808-Ljbffr

Emory Healthcare is seeking a remote Medical Coding Auditor to ensure the accuracy, completeness, and compliance of professional coding and clinical documentation. You will review patient records and collaborate with providers, coding teams, and compliance staff to support accurate coding and appropriate reimbursement. The role emphasizes audits, ongoing education on ICD-10, CPT, HCPCS, HIPAA, and regulatory standards. #J-18808-Ljbffr

University of Michigan's Michigan Medicine is seeking an experienced Coding Quality Auditor to perform outpatient coding audits for CPT/ICD-10-CM, ensuring accuracy and CMS guideline compliance. You will develop and deliver educational programs, and act as a subject matter expert for the outpatient coding department. The role requires coordinating training, providing feedback to improve code accuracy, and contributing to departmental policies and process improvements within Revenue Cycle #J-18808-Ljbffr

Emory Healthcare is seeking a remote Medical Coding Audit Specialist to ensure accurate coding and documentation for professional coding services. The role supports accurate reimbursement and regulatory compliance by reviewing patient records and collaborating with providers, coders, and compliance staff. Responsibilities include conducting chart reviews, identifying discrepancies, and participating in audits to uphold high coding standards. #J-18808-Ljbffr

McLaren Health Care Corporation seeks a Senior Medical Coding Auditor to guide ongoing coding education for physicians, coders, and CDI staff and to ensure accurate code assignment. You will audit inpatient and outpatient coding, validate POA indicators and support clinical validation initiatives with CDI. Experience includes 3 years in medical coding audits, familiarity with MS-DRG/APC systems, and related certifications such as RHIA/RHIT/CCS or CPC/CIRCC/ROCC. #J-18808-Ljbffr

Certified Professional Coder Consultant Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the...

Job Description Job Description Company Description More Than Just Care, It’s Community   Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.   If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be  Munson Material.  To us, that means teammates who live by our values of  excellence, teamness, positivity, creativity,  and a commitment to creating  exceptional experiences  for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You   Grow:  Tuition reimbursement, in-person and online development, and access to our career hub to...

Employment Type: Full time Shift: Description: Purpose Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: “patients” refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency &...

Job TitleUses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.Note: "patients" refers to patients, clients, residents, participants, customers, membersEssential FunctionsOur Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of...

The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network, and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer center. McLaren has 20,000 full-, part-time and contracted employees and more than 93,000 network providers throughout Michigan. Position Summary: Responsible for working with and providing on-going coding and documentation education (quarterly, annually and ad-hock) for physicians, coders, ancillary department staff, clinical documentation improvement (CDI), and other allied health professionals to improve...

Intermountain Health is seeking an RN Charge/Coding Auditor for fully remote engagement. The role audits clinical charges, supports denial reviews, and provides expert guidance on charging, documentation, and policy adherence across the revenue cycle. Requires BSN, active RN license, and coding certification (AAPC/AHIMA). The position emphasizes collaboration with care teams, regulatory knowledge, and ongoing education to reduce denials while maintaining compliance. #J-18808-Ljbffr

Position Summary: Responsible for working with and providing on-going coding and documentation education (quarterly, annually and ad-hock) for physicians, coders, ancillary department staff, clinical documentation improvement (CDI), and other allied health professionals to improve documentation of patient care and to appropriately assign codes and/or determine charges to support those services. Essential Functions and Responsibilities As Assigned : 1. Completes quality assurance audits on inpatient and outpatient coding specialists, onboarding audits and training of newly hired coding specialists, validating the coding specialist is accurately abstracting data into medical record systems, following coding guidelines and directives. 2. Validates Present on Admission (POA) indicators according to guidelines and identifies any missing or inappropriate queries to providers. 3. Uses payment methodology to audit outpatient and/or inpatient facility coding and billing,...

Job DescriptionJob DescriptionCompany Description More Than Just Care,It’sCommunity Imagine doing meaningful work in a place where peoplevacation.That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just beMunson Material.To us, that means teammates who live by our values ofexcellence,teamness, positivity, creativity,and a commitment to creatingexceptional experiencesfor our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country.Invested in You Grow:Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help you advance.Thrive:Full benefits, paid holidays,...

Become a part of our caring community The 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Certified Professional Coder ConsultantCome grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding.Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies.Our people are our future – we provide the venue for...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS code...

Trinity Health in Livonia, MI seeks an experienced Health Information Management Auditor with strong coding expertise to review complex procedures, CPT/ICD-10, HCPCS and HCC guidelines. You will conduct audits, provide feedback, and develop training materials for providers and coders. Responsibilities include analyzing documentation patterns, ensuring regulatory compliance, and supporting leadership with data-driven recommendations. #J-18808-Ljbffr

Humana is seeking a Medical Coding Auditor to review medical claims against records, ensuring CPT/HCPCS coding accuracy and guideline adherence. The role supports APC/outpatient coding, uses encoders, and performs CPT/HCPCS reviews while protecting patient confidentiality. You will work remotely with potential occasional travel for training or meetings, typical hours Monday–Friday, and focus on Outpatient Facility/APC coding teams with emphasis on accuracy and compliance. #J-18808-Ljbffr

About the role As a Medical Coding Quality Auditor, you will play a critical role in ensuring coding accuracy, compliance, and quality across healthcare records. You will collaborate with coding professionals and physicians to support accurate clinical documentation, regulatory compliance, and operational excellence while maintaining high quality and productivity standards in a remote work environment. In this role, you will: Review medical documentation to accurately assign diagnosis and procedure codes. Communicate with physicians and other healthcare providers to obtain or clarify diagnoses and procedures through the coding query process. Assign accurate codes using electronic encoder applications in accordance with company policies, coding guidelines, and regulatory requirements. Perform peer reviews and quality audits of Health Information Management coding auditors and coders. Prepare and complete reports, audit findings, and other deliverables as requested. Monitor...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...