49 compliance coding auditor jobs found

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

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, HCPCS and ICD-10 codes on an annual basis. The Senior Compliance Coding Auditor will have dotted line reporting to the Chief Compliance & Risk Officer. 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....

Job Title 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 Essential 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...

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 Essential 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...

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...

A healthcare organization is seeking a Senior Compliance Coding Auditor to perform coding audits and ensure adherence to regulatory standards. The ideal candidate will conduct chart reviews, identify discrepancies, and educate medical staff on coding practices. Preferred qualifications include a CPC or CCS certification, 4 years of experience, and knowledge of the Epic EHR system. This full-time role offers a competitive salary reflecting industry standards for healthcare compliance professionals. #J-18808-Ljbffr

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...

A healthcare organization is seeking a Compliance Billing & Coding Auditor to conduct audits ensuring compliance with regulations and organization policies. Responsibilities include auditing billing documentation, developing reports, and collaborating with teams to implement best practices. Candidates should possess an Associate’s degree, relevant experience, and certification in coding. This full-time position offers benefits including retirement plans and medical insurance, emphasizing a culture of care and compliance. #J-18808-Ljbffr

Compliance Billing & Coding Auditor page is loaded## Compliance Billing & Coding Auditorlocations: Business and Technology Centertime type: Full timeposted on: Posted Todayjob requisition id: R18998We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas.Job Summary The Healthcare Compliance Billing & Coding Auditor is responsible for performing independent audits of billing and coding practices across hospital departments and clinic providers to ensure compliance with organizational policies, federal and state regulations, and payer requirements. Reports to Chief Compliance Officer Job Specific Responsibilities 1. Conduct comprehensive audits of billing and coding documentation for accuracy and compliance in both hospital and clinic settings. 2. Identify discrepancies, potential compliance risks, and recommend corrective actions. 3. Develop audit reports and...

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

divh2Medical Coder Auditor/h2pRevenue Cycle Management is looking for a Medical Coder Auditor to join our team. Remote opportunity after 30-90 day in-person training./ppSUMMARY: The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives./ppESSENTIAL FUNCTIONS:/pulliConduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations./liliReview coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines./liliIdentify coding trends, error patterns, and compliance risks and develop corrective action plans./liliProvide feedback and education to coders to improve accuracy and consistency./liliCollaborate with providers and clinical...

Inpatient/DRG Validation Coding Auditor The 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. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Title: Compliance Auditor& Billing Data Analyst - Oncology Hub Locations : Atlanta, GA; Columbus, OH; Dallas, TX (Preferred) Onsite/Remote/Hybrid: REMOTE position Certification : Active CPC/COC/or ROCC certification (REQUIRED) Industry Experience : Healthcare background (REQUIRED) Experience : 4+ years healthcare coding experience using CPT, ICD10CM,...

Job Description Job Description 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...

A leading healthcare provider in Texas is looking for a Coding Auditor Senior. This on-site role with a remote option involves performing code audits, ensuring accurate documentation, and educating providers on coding practices. The ideal candidate will have at least three years of coding experience, strong communication skills, and certification through AHIMA or AAPC. The position requires a commitment to comply with guidelines and improve coding accuracy to enhance care quality and regulatory compliance. #J-18808-Ljbffr

The Compliance RCM Auditor is responsible for reviewing and verifying that a healthcare provider's revenue cycle management (RCM) practices adhere to all relevant compliance regulations, including coding guidelines, billing procedures, and patient demographic data, by conducting audits to identify potential issues and ensure accurate billing and patient record keeping, while recommending corrective actions to maintain compliance with federal and state laws. The Compliance RCM Auditor works independently performing program, compliance, and risk-based reviews of health care related activities to ensure accuracy of related medical record documentation, coding, billing and policies. Provides written audit summary of findings to include audit recommendations. Conducts revenue cycle investigations to determine and mitigate risk through findings, reports, and recommended actions Summary of Essential Job Functions The key responsibilities of the Compliance RCM Auditor include but...

Job Type Full-time Description At VMG Health, we're more than just a team of experts; we're trusted partners in the business of healthcare. Backed by a team of over 300 professionals and a history of more than 70,000 engagements since 1995, we bring experience, deep and wide, to every project. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms. Our solutions-oriented approach to client needs is bolstered by our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clients' valuation, strategic, and compliance needs. Requirements VMG Health is seeking a Coding/Compliance Auditor to perform all levels of documentation and coding reviews related to professional services as well as project management and report writing for VMG's Coding Audit and Compliance (CAC) team. The...

A leading healthcare company is seeking a Medical Coding Auditor to ensure medical claims accuracy and compliance. This remote role demands expertise in CPT/HCPCS coding and offers a competitive salary range of $59,300 to $80,900 per year. The ideal candidate will have at least 3 years of post-certification experience and strong analytical skills. Benefits include comprehensive health coverage, a 401(k) plan, and paid time off. Join a dedicated team committed to improving health outcomes. #J-18808-Ljbffr

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

Embedded Medical Coder We are seeking a detail-oriented and certified Embedded Medical Coder to join our healthcare team. This role involves working directly within a clinical or administrative unit to ensure accurate and compliant coding of medical procedures, diagnoses, and services. The ideal candidate will be embedded in day-to-day operations, collaborating closely with physicians, nurses, and billing staff to support efficient documentation and reimbursement processes. Key Responsibilities: Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes. Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards. Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies. Submit coded data to billing systems to initiate insurance claims and support reimbursement. Maintain and update patient data for long-term tracking and reporting. Participate in audits and...

Job Description A client of Innova Solutions is immediately hiring for a HIM Coder . Position type: Full-time, Contract Duration: 5+ Months Location: Remote (looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG‑related issues), and maintain adherence to coding standards and policies. Required Skills & Qualifications 2+ years of recent hospital coding/abstracting experience within the last 5 years (inpatient and/or outpatient). Certified Coding...

Revenue Integrity Analyst (Medical Biller) Guidehouse is seeking a Revenue Integrity Analyst (Medical Biller) with strong billing, coding, and revenue cycle expertise to support the modernization of MHS GENESIS, the DoD's enterprise EHR. The role ensures accurate billing, compliant charge capture, and efficient claim resolution by analyzing data, auditing documentation, and collaborating with clinical, coding, IT, and financial teams across the Military Health System. Responsibilities of this role are as follows, to include but not limited to: Support and optimize MHS GENESIS revenue cycle configuration, including charge capture workflows, billing rules, and work queues. Validate charge accuracy, coding logic, modifiers, and payer requirements; troubleshoot system and workflow issues. Analyze financial, clinical, and operational data to identify trends, charge variances, and revenue improvement opportunities. Investigate claim edits and denials, identify root causes, and...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, 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/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...