Auditor jobs | Healthcare Careers

Full Time

Coding Educator & Auditor Revenue Integrity (Remote Opportunity, Texas residents only)

UNIVERSITY HEALTH San Antonio, TX, USA

University Health is one of the largest employers in San Antonio. We are a nationally recognized teaching hospital and consistently recognized as a leader in advanced treatment options, new technologies and clinical research. Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery. We are currently looking for a talented health professional to join our team as a Coding Educator & Auditor for our Revenue Integrity department . This is an exciting opportunity to join a company with a reputation for exceptional service and patient care. The Position : Works under the direct supervision of the Coding Education & Audit Manager. Will perform any or a combination of the following types of coding education and audit: Basic ancillary services, Emergency Room services, Hospital Observation, Ambulatory surgery, Inpatient Admission. Utilizes the ICD-10-CM and CPT coding...

FS

Full Time

Medical Coding Auditor

Farragut Square Group Remote

Farragut Square Group provides clients with research and policy advisory services on a range of healthcare topics, including Billing and Coding Claims reviews of physician office practices and in and out-patient facilities. As part of our ongoing commitment to be #AlwaysBetter for our people, clients, and communities, we have created a culture of belonging that champions your individuality and authenticity as both a person and a professional. From our competitive compensation, top benefits and award-winning professional development programs to industry-leading wellness initiatives, we support you through every stage of your life and career so you can live a life you love both in and outside of the office. With us, you’ll find: A Firm where everyone belongs: Our award-winning culture prioritizes warmth and authenticity — we encourage you to be yourself! Enthusiasm for diverse perspectives: We’re smarter and stronger when everyone has a voice and...

EH

Full Time

Clinical Coding Auditor & Trainer

Elevance Health Remote

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. ***The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. *** Responsibilities: Conducts auditing of work performed by staff and present findings and recommendation for areas of improvement to management Under minimal supervision responsible for all aspects of auditing projects that are broad in nature and require originality...

Full Time

Registered Nurse CRC Coding Auditor - Remote

Conifer Health Solutions Remote

JOB SUMMARY The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and...

GX

Quality Auditor Supervisor - 1st Shift

GXO Pryor, OK, USA

Logistics at full potential. At GXO, we’re constantly looking for talented individuals at all levels who can deliver the caliber of service our company requires. You know that a positive work environment creates happy employees, which boosts productivity and dedication. On our team, you’ll have the support to excel at work and the resources to build a career you can be proud of. 1st Shift, Monday - Friday, 8:00am - 5:00pm The Quality Auditor Supervisor is responsible for overseeing and conducting internal audits to ensure compliance with quality standards, processes, and procedures. This role may involve leading a team of auditors, supporting the development audit schedules, analyzing audit findings, reporting out results, reviewing and approving corrective actions to improve processes. What you’ll do on a typical day: Team Leadership: Supervise, train, and mentor a team of quality auditors. Audit Planning: Develop and execute audit schedules based on processes, requests, and...

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Vendor Compliance Auditor

Capstone Logistics Selma, TX, USA

Selma, TX Monday - Friday 5:00AM - Finish $18 - $20 Hourly. paid weekly Vendor Compliance Auditor JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations QUALIFICATIONS: education and/or experience: High school diploma knowledge, skills and abilities: Demonstrated interpersonal and communication skills (written and verbal) Attention to detail Familiarity with pallet building standards Demonstrated commitment to safety standards physical requirements: Ability to...

CO

Coding Auditor - Risk Adjustment

CareOregon Billings, MT, USA

Get AI-powered advice on this job and more exclusive features. The Coding Auditor performs code audits and is responsible for chart auditing processes as well as contributing to the education of providers and internal stakeholders on coding topics. The position is responsible for keeping up to date on the newest coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Specific approaches to job duties vary depending on the department. Estimated Hiring Range $72,765.00 - $88,935.00 Bonus Target Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. Essential Responsibilities Perform and assist with a variety of coding-related audits for providers and other entities. Assist with RADV and other diagnosis code related audits (Applies to Finance department roles only). Review...

AA

Dealership Compliance Auditor

Asbury Automotive Sandy Springs, GA, USA

About Asbury Asbury Automotive Group (NYSE: ABG) is a Fortune 500 company and one of the largest franchised automotive retailers in the United States. We are redefining the traditional dealership model through innovative technologies such as Clicklane and through our commitment to our team members, guests, and partners. Our culture which is grounded in our North Star and Compass and powered by our DRIVE values, focuses on the vision of becoming the Most Guest Centric Automotive Retailer. At Asbury, we work together to provide exceptional experiences for our guests while promoting a fun, supportive and inclusive environment where team members can thrive both personally and professionally. Based on our efforts, we have been recognized as one of the best places to work by both Newsweek and US News & World report. The Dealership Compliance Auditor position assists the Director - Compliance in 1) promoting a culture of compliance through monitoring and reporting on...

NM

Medical Coding Auditor Evaluation & Management

New Mexico Staffing Santa Fe, NM, USA

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives...

KS

Medical Coding Auditor Evaluation & Management

Kansas Staffing Topeka, KS, USA

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives...

LI

CSCA Certified Social Compliance Auditor

Labtest International Inc Lowell, MA, USA

CSCA Auditor - Travel based Intertek, a leading provider of quality and safety solutions to many of the world's top-recognised brands and companies, is actively seeking a Supplier Management / Corporate Social Responsibility CSCA Auditor to join our Business Assurance team. This is a fantastic opportunity to grow a versatile career with a company that wants to build something great with an incredible group of people. Intertek's Business Assurance team goes beyond testing, inspection and certification to look at the underlying elements that make a company and its products successful. Our assurance solutions provide confidence and total peace of mind that a client's operating procedures, systems and people are functioning properly to provide a competitive advantage in the marketplace. What are we looking for? The CSCA Auditor will lead and/or participate as an assessor during all phases of a Supplier Management system audit in accordance with Intertek and Client social,...

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Compliance Auditor

Children's Home of Wyoming Conference Binghamton, NY, USA

Job Description Job Description WHO WE ARE : The Children's Home of Wyoming Conference partners with children, families and communities throughout New York State to inspire hope, develop skills and cultivate healthy relationships for positive futures. $20-23 an hour Position Summary: The PQI Compliance Auditor will ensure compliance activities, Agency audits, and standards for excellence are completed with a high level of attention to detail, organization, and collaboration. This position is responsible for working with teams across the Agency to ensure the identified criteria are met in practice through the process of auditing and reviews. This role serves as not only a monitor for compliance in a variety of areas, but also a catalyst for excellence in our field. The PQI Compliance Auditor will ensure the Agency is meeting the highest standards in practice, documentation, processes, and philosophy. Responsibilities: Provide detail-oriented reports in a...

VH

Medical Coding Auditor-Pea Ridge

Valley Health Systems Inc Huntington, WV, USA

Job Summary: The Medical Coding Auditor protects company assets by completing coding documentation and quality & program audits to ensure support of services billed, complying with all federal and state regulations and internal controls, and recommending improvements in internal control structure. Primary Responsibilities (illustrative): Follows established protocols, selects and reviews a percentage of records to assess coding documentation, billing and/or reimbursement practices for compliance with all regulations for federal and state agencies, third-party payers, and organization policy. Communicates audit progress and findings by preparing reports and providing information to the Compliance Officer, CMO, Medical Coding Lead, Compliance Specialist and Chief Quality Officer as needed. In conjunction with appropriate personnel, investigates, evaluates, and identifies opportunities for improvement, recognizes their relative significance in the overall system, and...

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Regulatory Services Coding Auditor

Physicians East Greenville, NC, USA

Job Title: Regulatory Services Coding Auditor About us Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina. About the role We are looking for an employee that can work in a fast-paced office setting to conduct in-house audits, provider education, and provide coding related support to expedite the billing process. Additionally, proactively appeals, and assists with rebilling of claims addressing identified errors. Predominantly remote position with periodic travel to Physician's East locations to deliver audit findings and conduct provider education. A period of training will be required on site . Applicant must be located in North Carolina. Supervision Received: Reports to Regulatory Services Manager. Supervision Exercised: Limited. Typical Physical Demands: Requires prolonged standing or sitting while...

KP

Coding Compliance Auditor - Maui Health

Kaiser Permanente Wailuku, HI, USA

Coding Compliance Auditor - Maui Health HIM Coding auditor/trainer will coordinate, monitor, and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-10, ICD-9-CM, HCPCS codes and clinician documentation to ensure that Kaiser Permanente is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities. The auditor will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, this position will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, Revenue Cycle, External and Internal practitioners, and other regional departments...

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Behavioral Health Coding Auditor

Shyft6 Spokane, WA, USA

Behavioral Health Coding Auditor (Consultant) This is a remote position. We are seeking a Certified Medical Coder with deep Behavioral Health expertise to audit current coding practices and outcomes for a healthcare payer organization. The consultant will assess provider-facing coding (CPT, HCPCS, ICD-10) in the Behavioral Health domain, identify issues, and recommend rule definitions and process improvements to optimize accuracy and reimbursement. Experience configuring payer platformsespecially HealthEdge HealthRules or Optum equivalentsis a strong plus. What You'll Do Perform retrospective and prospective audits of Behavioral Health claims and encounters (CPT/HCPCS/ICD-10). Evaluate accuracy, completeness, and adherence to payer and Medicaid guidelines with emphasis on Rhode Island Medicaid policy requirements. Analyze denial trends, under/overpayments, edits, and provider coding patterns; quantify impact and root causes. Draft clear, actionable coding rule definitions...

MS

Medical Coding Auditor Evaluation & Management

Missouri Staffing Jefferson City, MO, USA

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives...

HI

Medical Coding Auditor Evaluation & Management

Humana Inc Concord, NH, USA

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

MS

Medical Coding Auditor Evaluation & Management

Mississippi Staffing Jackson, MS, USA

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives...

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Compliance Auditor/Educator - RSO - Remote

Trinity Health Ann Arbor, MI, USA

POSITION DESCRIPTION: The Compliance Auditor/Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding. The Compliance Auditor/Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations. This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution. Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance. ESSENTIAL JOB FUNCTIONS: Develops and leads audit projects for medical record integrity, service line or issues-related...

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Compliance Auditor 2-Physician

Loma Linda University San Bernardino, CA, USA

Shared Services: Compliance- (Full-Time, Day Shift) Job Summary The Compliance Auditor-Physician monitors and audits established mechanisms and controls to ensure compliance with regulations. Audits the activities of various departments for compliance with plans, policies and procedures prescribed by management. Prepares and submits reports on the results of audits, recommending improvements in policies and procedures. Cooperates with outside auditors in any undertaking that may expedite their work. Performs other duties as needed. Conducts full range of physician-based audits/projects and develops partnerships with internal and external customers. Performs other duties as needed. Education and Experience Bachelor's Degree required. Master's Degree preferred. Minimum three years of experience in auditing within healthcare, compliance, regulatory oversight agency, quality management, quality assurance or business analysis. Knowledge and Skills Experience with...

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Staff Coding Compliance Auditor (medical billing and coding)

Geisinger Baton Rouge, LA, USA

Compliance Auditor The Compliance Auditor position is responsible for supporting the organization's Revenue Management Compliance department in developing, implementing, and administering an effective compliance program. Accurately audits and provides compliance research support to physicians, non-physician practitioners, leadership, and administrative staff on documentation and coding requirements. Determines the adequacy of medical record documentation, coding, and billing, using established compliance auditing and research guidelines for hospital and professional services. Job Duties: Performs compliance audits to determine the adequacy of medical record documentation, billing, and coding, utilizing policies, procedures, Federal and State, laws, regulations, and standard coding guidelines. Evaluates whether documentation and coding patterns present a compliance risk to the organization and provides input on recommended solutions. Identifies training and education needs...

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Vendor Compliance Auditor

Capstone Logistics Baton Rouge, LA, USA

Baton Rouge, LA Pay: $18.00 / Hourly 9:30PM-Finish | Schedule set at time of hire Vendor Compliance Auditor JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations QUALIFICATIONS: education and/or experience: High school diploma knowledge, skills and abilities: Demonstrated interpersonal and communication skills (written and verbal) Attention to detail Familiarity with pallet building standards Demonstrated commitment to safety standards physical requirements:...

CL

Vendor Compliance Auditor

Capstone Logistics, LLC Layton, UT, USA

Position Vendor Compliance Auditor Shift 7:00pm-Finish 10:00pm-Finish Compensation $18.00 paid hourly Location Layton, UT Job Summary This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. Supervisory Responsibilities None Essential Functions / Responsibilities Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations Other Information Job ID: CAP24691 Capstone Logistics, LLC is part of The Transportation and Logistics industry which has been designated a "Critical Infrastructure Segment". As a "critical infrastructure industry" worker in the Transportation and Logistics industry, associates are considered exempt from local restrictions such as curfews,...

1339 auditor jobs found