87 compliance coding auditor jobs found

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...

FlexStaff - Head Surgical Coding Manager & Compliance Auditor Are you a seasoned coding professional with a passion for accuracy, compliance, and team leadership? Do you thrive in a fast-paced healthcare environment and want to make a real impact? FlexStaff wants you to lead our client's anesthesia and procedural coding efforts! The Head Surgical Coding Manager & Compliance Auditor play a pivotal role in ensuring the organization's coding excellence, compliance, and revenue integrity. Ready to lead the charge in healthcare coding excellence? Don't miss this incredible opportunity to make a difference! Responsibilities: Must have Leadership & Surgical Coding Experience. Lead and inspire a team of Coding Team Leads, fostering a culture of accuracy and continuous improvement Oversee all anesthesia and procedural coding, ensuring compliance with the latest regulations and payer guidelines Conduct meticulous audits, identify discrepancies, and...

Job Description FlexStaff - Head Surgical Coding Manager & Compliance Auditor Are you a seasoned coding professional with a passion for accuracy, compliance, and team leadership? Do you thrive in a fast-paced healthcare environment and want to make a real impact? FlexStaff wants you to lead our client's anesthesia and procedural coding efforts! The Head Surgical Coding Manager & Compliance Auditor play a pivotal role in ensuring the organization's coding excellence, compliance, and revenue integrity. Ready to lead the charge in healthcare coding excellence? Don't miss this incredible opportunity to make a difference! Responsibilities: Must have Leadership & Surgical Coding Experience. Lead and inspire a team of Coding Team Leads, fostering a culture of accuracy and continuous improvement Oversee all anesthesia and procedural coding, ensuring compliance with the latest regulations and payer guidelines Conduct meticulous audits, identify...

Req Number 177401 FlexStaff - Head Surgical Coding Manager & Compliance Auditor Are you a seasoned coding professional with a passion for accuracy, compliance, and team leadership? Do you thrive in a fast-paced healthcare environment and want to make a real impact? FlexStaff wants you to lead our client's anesthesia and procedural coding efforts! The Head Surgical Coding Manager & Compliance Auditor play a pivotal role in ensuring the organization's coding excellence, compliance, and revenue integrity. Ready to lead the charge in healthcare coding excellence? Don't miss this incredible opportunity to make a difference! Responsibilities: Must have Leadership & Surgical Coding Experience. Lead and inspire a team of Coding Team Leads, fostering a culture of accuracy and continuous improvement Oversee all anesthesia and procedural coding, ensuring compliance with the latest regulations and payer guidelines Conduct meticulous audits,...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Coding Auditor & Educator (Remote | Contract-to-Hire) Our Client seeks an experienced Coding Auditor & Educator to support provider-based coding compliance and education across a large, complex health system. Key Responsibilities Audit and provide education for PB E/Ms, Diagnosis coding, and in-office procedures Audit 100 coders per quarter, reviewing 30 charts per audit Support audits across 1,000+ providers Deliver clear, actionable feedback to improve coding accuracy and compliance Qualifications Certifications: AAPC or AHIMA (RHIA or RHIT required) Strong knowledge of Professional-Based E/M and Diagnosis coding Preferred experience in Cardiology and/or Emergency Department coding Experience in large healthcare systems (500+ beds, Level 1 Trauma or Teaching Hospitals; ICU exposure preferred) Ability to quickly adapt to new workflows and work independently MD Audit experience a plus (training provided if needed) Systems EPIC 3M 360 CAC Position Details...

Overview Hi, we\'re Oscar. We\'re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Coding Auditor & Provider Educator NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona. NAH currently hires for remote positions in the following states: Alabama Arizona Florida Georgia Idaho Indiana Kansas Michigan Missouri North Carolina Ohio Oklahoma Pennsylvania South Carolina Tennessee Texas Virginia The Coding Auditor & Provider Educator is a critical role responsible for ensuring the accuracy, completeness, and compliance of medical coding (CPT, HCPCS, ICD-10-CM) for professional services. This individual will conduct thorough coding audits, identify areas for improvement in documentation and coding practices, and develop and deliver targeted educational programs to physicians, advanced practice providers (APPs), and clinical staff. The primary goal is to optimize revenue integrity, mitigate compliance risks, and foster a culture of accurate and compliant documentation and...

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery, Peds...

divh2Coder Quality Auditor/h2pThe Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties./ppJob Responsibilities:/pulliQuality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess...

divh2Inpatient/DRG Validation Coding Auditor/h2pThe Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations./ppHas an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems./ppConducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding,...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers. Researching state and...

Z. Wilson Talent Solutions is proud to partner with a premier healthcare organization to recruit experienced Inpatient Coding Auditors for a full-time, fully remote opportunity. This role is open to qualified candidates across the United States and offers a competitive salary, annual bonus, comprehensive benefits, and paid overtime. Whether you’re an experienced auditor or a highly skilled inpatient (facility) coder ready to take the next step, this role provides a meaningful path forward. Candidates with strong inpatient coding expertise and a solid understanding of DRG reimbursement will receive training and support to develop auditing capabilities. About the Role As an Inpatient Coding Auditor, you will play a critical role in ensuring accurate DRG assignment, compliant documentation, and appropriate reimbursement. Working closely with physicians and internal stakeholders, you’ll combine your clinical coding expertise with advanced technology and analytics to support quality,...

Overview Employer Industry: Healthcare Services Why consider this job opportunity: Estimated pay range of $26.13 - $33.97 per hour, depending on experience Opportunity for career advancement and growth within the organization Supportive and collaborative work environment focused on quality care Chance to make a positive impact on coding compliance and education for healthcare providers Work with a renowned healthcare organization recognized for excellence in patient care What to Expect (Job Responsibilities) Perform comprehensive audits to assess the integrity of coding and billing for physician and clinical fees Identify and correct documentation, coding, and billing errors as well as evaluate medical necessity of services billed Develop and execute educational opportunities and resources based on audit results and coding compliance trends Lead provider education events to discuss audit results and implement action plans Establish positive working relationships as a subject...

A leading healthcare organization in New York is seeking a Coding Auditor to perform comprehensive audits and ensure coding compliance. The ideal candidate will have over 4 years of experience in physician coding, proficiency in various coding systems, and a strong attention to detail. This role offers a collaborative environment focused on quality care and opportunities for career growth. Candidates must hold relevant certifications and demonstrate excellent organizational skills. #J-18808-Ljbffr

Job DescriptionDepartment / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20Professional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding / charging / denials follow-up.Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.Provide education, instruction and training to providers and coding staff.This position is remote but does require onsite education to providers as needed.This position has remote opportunityThis position requires a CPC Certification - Upon HireTwo years or more prior experience in professional fee coding - requiredEssential...

Job TypePart-timeDescriptionRequired :3-5 years of experience in acute care facility (hospital) medical coding auditing or complianceLocation :RemoteJob Summary :The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements.This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies.Occasional travel may be required for audits or meetings.Key Responsibilities :Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance.Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines.Identify and address coding discrepancies and recommend corrective actions.Prepare detailed audit reports with findings and provide feedback on documentation and coding practices.Collaborate with relevant departments to resolve audit findings and...

Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in healthcare compliance...

Job Description Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

Position Overview Responsible for the accurate and compliant coding of inpatient, outpatient, and professional OB/GYN encounters. This position serves as a key liaison between coding, clinical, and compliance departments ensuring that all documentation and coding practices meet regulatory and payer requirements. The role also includes providing ongoing education to OB/GYN providers and clinical staff on documentation quality, coding updates, and best practices to optimize compliance and reimbursement. Tasks and Responsibilities Coding and Documentation Review: Assign accurate ICD-10-CM, CPT, and HCPCS codes for all OB/GYN-related inpatient and outpatient encounters, including deliveries, surgeries, procedures, and E/M services. Apply knowledge of global obstetric coding, cesarean and vaginal deliveries, postpartum care, and gynecologic surgeries (e.g., hysterectomy, laparoscopic procedures). Review provider documentation to ensure completeness and accuracy...

Become a part of our caring community and help us put health first 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. 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...