20 physician compliance 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...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

The Medical Group Compliance Auditor Senior is responsible for providing audit, coding support and guidance to physicians, APPs, residents and support staff. This role ensures that all coding, billing and documentation complies with federal and/or state regulations, private payer health care program requirements as well as the Compliance and Operations Policies of the organization. This job assists with the development and implementation of educational and training programs as well as coding tools and resources to help achieve organization?s goal of consistent, complete and accurate coding and documentation. Essential Job Function Capable of working independently to conduct regularly scheduled compliance reviews for assigned providers, practices, and focused review areas within designated time frames. Provides mentorship and guidance to the more junior Medical Group Compliance Auditor during the audit completion process. Performs Reviews clinical documentation to...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department...

Senior Coding Compliance Auditor and Educator Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Senior Coding Compliance Auditor and Educator 3 days ago Be among the first 25 applicants Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Get AI-powered advice on this job and more exclusive features. General Job Summary : The Senior Coding Compliance Auditor and Educator will be responsible for auditing outpatient professional services documentation ensuring compliance with coding and billing guidelines, identifying areas for improvement, and providing training to clinicians and coders to support accuracy, compliance, and adherence to industry standards. This role involves both auditing medical records and educating coders, providers, and staff on professional coding guidelines and best practices. (this is a full-time position that will support our Compliance team, Monday to...

Select how often (in days) to receive an alert: Work Arrangement: Hybrid (On‑Site and Remote mix) Requisition Number: 263058 Regular or Temporary: Regular Location: Durham, NC, US, 27710 At Duke Health, we’re driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Compliance Auditor 5119 - G1 Occupational Summary Conduct health‑system wide compliance audits to ensure data integrity and compliance with federal and state regulations pertaining to, but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, anti‑kickback and physician relationships. Exercise independent decisions using analytical and problem‑solving skills. Provides critical analytical and support with respect to third‑party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed...

Job Description Job Description Description: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF)...

Job Description Job Description SUMMARY:  Responsible for billing team leadership, subject matter expertise and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for Medical and Dental services rendered by First Choice Community Health Center (FCCHC) providers. Supervises billing specialists to ensure all tasks are completed timely and accurately. The Revenue Cycle Manager is expected to devote 50% of work time to learn leadership and subject matter expert responsibilities.  The Revenue Cycle Manager should proactively seek to further develop billing process competencies; and assist in implementation of process improvements.  ESSENTIAL DUTIES AND RESPONSIBILITIES Team Leadership Supervise and coordinate the workload of the billing staff to ensure all task are completed accurately and in a timely manner. Define and communicate current and new billing tasks and definitions of the billing team. Recommend and report billing...

Contract Compliance Manager (CCM) / Night Auditor Are you experienced in building maintenance, housekeeping, hotel supervision, or similar industries? Do you have strong management experience and good communication skills? Are you seeking a full-time evening shift position? If you answered yes, consider this great opportunity with City Wide! We are seeking a Contract Compliance Manager (CCM) / Night Auditor to join our team in Charlotte! The CCM is responsible for assisting with management of contract compliance for designated building maintenance services, as well as maintaining the relationship between City Wide and Independent Contractors. Employee must possess the ability to review the client contract and check that work expectations have been met. City Wide Facility Solutions, the nation's leading management company in the building maintenance industry, provides solutions to a wide range of issues clients face at their facilities. We offer competitive pay, benefits within a...

Essential Elements As a Biltmore Farms Night Auditor / Front Desk Supervisor, you are more than just a welcoming presence; you are the first impression our guests have of our hotel and city. The ideal candidate has good communication skills along with mathematics and accounting experience. The Night Auditor / Front Desk Supervisor also fulfills the role of overnight Manager on Duty, which is responsible for the security of the hotel property, completes a Manager on Duty daily report, and has authority to make guest-related decisions for the hotel in the absence of the General Managers. Night Auditor / Front Desk Supervisor – Responsibilities Serves as the Manager on Duty during the overnight hours in the absence of Front Office Manager and/or Assistant General Manager. Uses critical thinking and creative management skills to solve guest and team member problems. Ensures compliance with company standards to ensure consistent high-quality guest relations. Manages desk, resolves...

Certified Professional Coder, Independent Contractor Constellation Quality Health is a non‑profit health care quality consultancy and QIO‑like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You’ll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor’s degree required in a human services field or five (5) years of related experience may substitute for degree. Certified...

Are you an experienced Medical Coder seeking a career growth? Are you a Certified Auditor interested in a new work opportunity? If so, then we want to connect with you! MAHEC is now accepting candidates for Medical Auditor. This integral role supports MAHEC's mission of educating the next generation of healthcare professionals by completing internal quality assessment reviews on Care Provider coding and effectively builds relationships with MAHEC Care Providers to educate and foster complete, accurate, timely, and consistent coding. The Auditor/Provider Educator is responsible for documentation to ensure compliance with national coding guidelines and MAHEC policies. We welcome experienced Medical Coders interested in becoming a Certified Professional Medical Auditor, and MAHEC offers an employer-sponsored pathway to CPMA certification if hired for the position! This is a hybrid work opportunity, with roughly 50-60% onsite work to support in-person collaboration and...

Candidate should ideally be located in Charlotte, NC Monro’s family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach.  Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company’s regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color.  Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry.  Do you have what it takes to shape a...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Firsthealth Of The Carolinas FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area's only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our educational...

Company Description Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire and auto service in the industry. Candidate should ideally be located in Charlotte, NC Job Description Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish...

Summary Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. Duties & Responsibilities Responsible for the assignment of accurate E&M, ICD, CPT, and HCPCS codes and modifiers from medical record documentation. Identifies and abstracts information from medical records (paper or electronic) for special studies and audits, internal and external. Interacts with MTF staff to ensure documentation is clear and supports coding assignments. Educates MTF staff through individual or group in-services and training sessions. Maintains a delinquency report of missing records to facilitate completion of work within required...

Apply for the Coding Auditor, Physician Group role at ECU Health . Responsible for the creation and maintenance of audit and education programs that ensure success for all staff and employed providers, supporting accurate, compliant coding practices for ECU Health physicians in accordance with coding guidelines. Conduct internal audits of medical coding activities using concurrent, prospective, and retrospective models as appropriate. Review electronic health information to determine accuracy of coding, billing, and documentation, including validation of ICD‑10‑CM, CPT, HCPCS, and modifier assignments related to medical provider professional Part B services according to regulatory and institutional policy. Report findings, written and verbal, to leadership as necessary to include provision of corroborating regulatory or policy guidance. Maintain documentation of all audit activities and communicate findings to leadership. Utilize findings to generate topics for education and...

Picture Yourself at Biltmore Farms as part of the Vanderbilt legacy of hospitality! Why join our Front Office team as a Night Auditor / Front Desk Supervisor? $18.50/hour starting pay Outstanding medical, dental, and vision benefits coverage Fun wellness program with annual bonus of up to $600 401K retirement plan with employer matching program Opportunities to earn e-tips directly from guests and clients Parental leave with up to 6 weeks available for birth, adoption, and fostering Hilton-brand hotel discounts for you, your family, and your friends YMCA membership monthly discount Paid time off and paid holidays Friendly and supportive work environments Incredible employee learning and growth opportunities Exciting employee events and activities Essential Elements As a Biltmore Farms Night Auditor / Front Desk Supervisor, you are more than just a welcoming presence, you are the first impression our guests have to our hotel and to our city....

Description Are you have experience in building maintenance, housekeeping, hotel supervisor, janitorial or similar industries?  Do you have strong management experience and good communication skills? Are you seeking a full-time evening shift position? If you answer yes, consider this great opportunity with City Wide! We are seeking a Contract Compliance Manager (CCM) / Night Auditor to join our team in Charlotte! The CCM is responsible for assisting with management of contract compliance for designated building maintenance services, as well as maintaining the relationship between City Wide and Independent Contractors. Employee must possess ability to review the client contract and check that work expectations have been met. City Wide Facility Solutions , the nation’s leading management company in the building maintenance industry, provides solutions to a wide range of issues clients face at their facilities. We offer competitive pay, benefits within a collaborative and...