1116 healthcare compliance auditor jobs found

Licking Memorial Health Systems in Newark, Ohio is seeking a qualified healthcare compliance auditor with a nursing background to ensure Medicare/Medicaid documentation and billing accuracy. Under the VP of Financial Services, you will audit home care, patient status, and billing processes to support state and federal requirements. This role emphasizes collaboration with physicians and staff, confidentiality, and error analysis, with no remote work. #J-18808-Ljbffr

The Healthcare Compliance Auditor Senior I plays a key role in supporting UPMC's compliance and regulatory oversight activities through the identification, assessment, and mitigation of healthcare compliance risks. Leveraging expertise in healthcare operations, reimbursement methodologies, and regulatory requirements, this position conducts auditing and monitoring activities and collaborates with clinical, operational, revenue cycle, and compliance stakeholders to promote adherence to regulatory requirements. This is a full-time position that works Monday through Friday during normal business hours. The role follows a hybrid work model, with a combination of remote work and on-site attendance at UPMC's USX office. If this sounds like the role for you, apply today! Responsibilities: Must have knowledge of medical terminology, HIM coding, and reimbursement methodologies. Has working knowledge of internal policies and external regulatory requirements (e.g., Medicare,...

We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at the Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs...

Healthcare Compliance AuditorEmpowering Wellness, Transforming LivesOptima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we...

A non-profit health organization based in Alaska is looking for a Compliance Auditor to ensure compliance with healthcare regulations and coding requirements. The role involves conducting audits, analyzing data for compliance issues, and preparing detailed reports. Ideal candidates will have at least three years of experience in compliance auditing and relevant certifications. This position offers a comprehensive benefits package including retirement, paid time off, health insurance, and more. #J-18808-Ljbffr

Elara Caring is seeking a Senior Compliance Auditor to join our team, focusing on comprehensive audits across skilled home health, hospice, PCS, and behavioral health. You will analyze billing trends and guide agency leaders with actionable education and recommendations. Requirements include an RN license with a BSN/ASN, 5+ years in healthcare coding/billing compliance, and 2+ years of leadership. Certifications (HCS-D/COS-C) or willingness to obtain within a year are expected. Travel minimal. #J-18808-Ljbffr

Centriaautism in Farmington Hills seeks a Compliance Auditor to design and execute internal compliance audits. You will coordinate responses to external audits and monitor corrective actions. The role involves understanding payor requirements and compliance processes while working in a hybrid schedule. Candidates should have an Associate degree, knowledge of healthcare compliance, and excellent communication skills. Salary ranges from $55,000 to $70,000 annually with opportunities for professional growth. #J-18808-Ljbffr

Akron Children's Hospital seeks a Healthcare Compliance Senior Auditor to plan and execute in-depth audits, analyze risks, and guide corrective actions to uphold regulatory standards. You will develop components of the Compliance Program and deliver training across staff and leadership. The role reports to the Compliance Manager and involves cross-functional work to embed compliance into daily operations, with a focus on HIPAA, Medicare/Medicaid, and related statutes. Onsite, full-time position. #J-18808-Ljbffr

CenterLight Health System is seeking a Compliance Auditor in New York, NY. The role involves ensuring adherence to all relevant regulations through audits, conducting risk assessments, and developing audit plans. Candidates should have a Bachelor's degree and a minimum of three years' experience in healthcare audits. The position provides a salary range of $90,000 to $100,000 annually and requires strong analytical skills and an understanding of Medicare and Medicaid programs. #J-18808-Ljbffr

Prism Health North Texas is seeking a Compliance Auditor to join our Legal Affairs and Compliance team. This role conducts audits across clinical, grant, privacy, billing, and documentation areas and reports findings to governance committees. The ideal candidate has a bachelor's in a related field and at least three years in healthcare compliance, auditing, or risk management, with strong analytical and communication skills. #J-18808-Ljbffr

CenterLight Health System is seeking a Compliance Auditor to foster compliance with relevant laws and regulations. The auditor will conduct audits, develop risk assessments, and implement audit programs, partnering with operational leaders. Qualified candidates will have a Bachelor's degree and a minimum of three years of experience in Healthcare Audit. The role offers a salary range of $90,000.00 - $100,000.00 with a standard 40-hour workweek. #J-18808-Ljbffr

A leading healthcare institution in Akron, Ohio is seeking a Healthcare Compliance Senior Auditor to ensure adherence to healthcare regulations and internal policies. Responsibilities include conducting compliance audits, analyzing risks, and guiding corrective actions. Candidates should have a Bachelor's degree and at least 5 years of relevant experience. Strong knowledge of healthcare laws, along with certifications such as CHC, CPA, or CIA is preferred. The role offers an opportunity to impact compliance culture significantly. #J-18808-Ljbffr

Akron Children's Hospital is seeking a Healthcare Compliance Senior Auditor to strengthen the program by planning and executing audits, assessing risks, and guiding corrective actions. You will help develop policies, procedures, training modules, and monitoring systems in alignment with federal and state regulations. Reporting to the Compliance Manager, the role emphasizes cross‑functional collaboration, investigation leadership, and a strong focus on HIPAA, Medicare/Medicaid, and fraud statutes #J-18808-Ljbffr

Covenant Health in Knoxville, TN seeks a Compliance Auditor Sr. who will lead complex internal auditing efforts, ensuring compliance with billing and coding regulations. You will evaluate risk areas and document audit findings while mentoring department staff. A successful candidate will have a deep understanding of healthcare billing, at least five years of experience in the healthcare sector, and relevant certifications. The position demands skills in problem-solving and public relations in a fast-paced environment. #J-18808-Ljbffr

Covenant Health in Knoxville, TN is looking for a Compliance Auditor to perform internal audits and ensure compliance with coding and billing regulations. The ideal candidate will have 3-5 years of healthcare experience, expertise in billing compliance, and possess the necessary certifications like RHIT or RN License. Employment offers a full-time role with a day shift schedule and competitive pay. #J-18808-Ljbffr

Akron Children's Hospital is seeking a Healthcare Compliance Senior Auditor to plan and execute comprehensive audits across finance, operations, and research. You will analyze findings, draft actionable reports, and guide corrective actions to strengthen our compliance program. Reporting to the Compliance Manager, you will develop training modules, policies, and monitoring tools, mentor guest auditors, and collaborate with clinical and administrative leaders to integrate compliance into daily #J-18808-Ljbffr

Southern Arkansas University is hiring a Compliance Auditor to oversee the organization's adherence to healthcare regulations. The position requires at least 3 years in healthcare compliance and 2 years of auditing experience, along with a strong analytical skill set. Responsibilities include conducting audits, assessing compliance risks, and preparing reports. This part-time role offers $19 per hour for 20 hours of work per week, primarily remote with occasional in-office time required in Orlando. #J-18808-Ljbffr

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

Essen Medical Associates is seeking a Healthcare Compliance Specialist to ensure adherence to healthcare regulations. This role requires conducting audits, monitoring processes, and collaborating across divisions to implement corrective actions. The ideal candidate must have a Bachelor’s degree, clinical experience, and strong analytical skills. Essential duties include compliance audits, reviewing patient care workflows, and supporting training programs. #J-18808-Ljbffr

A healthcare organization in New York seeks an experienced individual to safeguard revenue and reputation through auditing and compliance activities. Responsibilities include conducting medical record audits, developing formal reports for senior management, and coordinating education sessions for over 500 health professionals. The ideal candidate must have a Bachelor's degree, at least 5 years of relevant experience in billing and coding, and excellent communication skills. #J-18808-Ljbffr

A health services firm in Pawleys Island seeks a candidate to perform compliance audits, focusing on CMS, CPT, and ICD-10 guidelines. This role involves reviewing records for accuracy, conducting educational summation conferences with clients, and maintaining communication throughout the review process. Ideal applicants should have a high school diploma coupled with an AAPC credential and a minimum of 5 years' experience in a multispecialty clinic. Strong communication, organizational, and critical thinking skills are essential for success in this position. #J-18808-Ljbffr

Healthcare Management Solutions, LLC is seeking a Senior Healthcare Compliance Reviewer to support federal oversight activities ensuring marketplace insurers comply with regulatory standards. The role analyzes policies, procedures, and supporting documentation and documents review results. The senior position requires strong analytical skills, attention to detail, professional communication, and the ability to manage competing priorities while handling sensitive information in a confidential #J-18808-Ljbffr

SCAN Group is seeking an experienced Auditor‑Lead to supervise a team performing DHCS and CMS auditing across its MCP. The role ensures initial and ongoing reviews of PCP sites, with a focus on safety, quality and regulatory compliance. You will generate audit assignments, verify documentation, and support CSR certifications. The position emphasizes collaboration with Compliance and Clinical teams, training staff, and maintaining up‑to‑date processes in line with NCQA, DHCS, and CMS #J-18808-Ljbffr

Covenant Health in East Tennessee is seeking a qualified internal auditor to perform complex compliance audits across charging, coding, documentation and billing processes within our system. The role reports to the Compliance Audit Manager and works with physicians, clinical management, and staff to mitigate risk. The successful candidate will review Medicare/Medicaid guidelines, stay current on payer rules, and coordinate with various departments to resolve overpayments, document findings, and #J-18808-Ljbffr