10 provider coding compliance auditor jobs found

Risk Adjustment Auditor and Physician Educator Health Information Management | Full-Time | Renton, Washington Help Improve Clinical Documentation and Support Better Patient Care Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide. The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education , along with the ability to translate complex coding and documentation requirements into practical guidance for providers. This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and...

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute  Boston, MA  Full Time, Remote (Occasional Onsite)  Overview Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist is responsible for designing, implementing, and maintaining a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards. This role develops and delivers training for billing providers, including physicians and advanced practice providers, and provides post-review education and feedback in collaboration with Billing Compliance Reviewers and Senior Billing Compliance Reviewers, as needed. The Specialist creates, updates, and manages instructional materials such as presentations, tip sheets, slide decks, and other training resources, and tracks training completion and effectiveness. The position also supports the...

Multiple ED, SDS and IP Coding Assignments Available & Data Quality Auditors Needed Description: Coders and Auditors with 3-5+ years of facility coding experience are needed to provide coverage to Pena4’s clients. Responsibilities : Pena4 M edical Coders are responsible for accurately assigning ICD-10-CM/PCS diagnosis and CPT procedure codes for inpatient and outpatient hospital services. This role ensures coded data is complete, compliant, and supports appropriate reimbursement, quality reporting, and regulatory requirements. Coders must meet or exceed determined productivity and quality standards for respectively assigned client engagements in order to ensure the highest level of coding.  Summary: Position Type: 1099 Independent Consultant 100% Remote Assignments Schedule/Shift varies per assignment. See current assignment details below.   Credentials: CPC, CCS, RHIA, RHIT (preferred) 3-5+ years of Facility Coding Will be required to complete ED,...

About Bridge Bridge is the fastest, most compliant way to scale insurance billing nationwide. We enable virtual care companies to go in-network nationally in as little as 30 days, without the operational lift. Our platform handles payer contracting, credentialing, real-time benefit verification, medical coding, claim submission, denial management, and compliance in a single integrated solution. Backed by leading investors including General Catalyst, Andreessen Horowitz, Thrive Capital, Khosla Ventures, Greenoaks, and Mischief, we're scaling rapidly. The Role We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and...

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...

About Med USA Med USA is a Utah-based medical billing/provider services company with a nationwide presence. We have been in business for over 45+ years and provide practice management, payer credentialing and contracting, and full-cycle management (RCM) services, including coding, billing, follow-up, and denial resolution. Join our fast-paced, high-energy team as a medical billing specialist, with great company benefits and opportunity for growth. The ideal candidate is motivated, professional, and detail-oriented, with a strong commitment to producing high-quality work and making a positive impact on the team. If you enjoy helping others, solving problems, and working in an open, collaborative, fast-paced environment, this is a great opportunity for you. Medical billing or insurance experience is preferred, but we’re happy to train the right candidate. Position Summary The Certified Medical Coder is responsible for reviewing clinical documentation and...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...