715 billing and coding auditor jobs found

Description Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations. As a nationally recognized provider of addiction and mental health care accredited by The Joint Commissionwith 18 locations, robust Telehealth services, and backed by TPGs Rise Fund since 2023our 1,600+ employees are dedicated to delivering compassionate, high?quality care that transforms lives. Positions Details Location: Flexible |On-site (Pompano Beach, FL), Hybrid or Remote (USA) Reports to: Auditing Manager & Director of RCM Schedule: Full-time Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and compliance. Review coding...

Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and Coding Auditor to support the accuracy and compliance of our billing practices across our behavioral health services. This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations. As a nationally recognized provider of addiction and mental health care accredited by The Joint Commission—with 18 locations, robust Telehealth services, and backed by TPG’s Rise Fund since 2023—our 1,600+ employees are dedicated to delivering compassionate, high-quality care that transforms lives. Positions Details Location: Flexible |On-site (Pompano Beach, FL), Hybrid or Remote (USA) Reports to: Auditing Manager & Director of RCM Schedule: Full-time Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and compliance. Review coding of all services...

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...

Job Description: This position is 100% on-site in Flowood, Mississippi Job Summary: The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers. The Senior Clinical Compliance Auditor collaborates with data analysts, compliance auditors, and the Medical Director to identify aberrant trends in patient care, utilization, and billing practices. The incumbent works with a multidisciplinary team to determine appropriate interventions to address and resolve identified...

Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. At Health Ministries Clinic, we offer more than just primary care with a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental. We are seeking an experienced Coding Auditor with a multi-speciality coding background. The Coding Quality Auditor is responsible to ensure Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations. The Coding Auditor plays a crucial role in minimizing coding errors and preventing fraudulent activities. The Coding Auditor is responsible to ensure accurate and consistent coding which results in appropriate reimbursement and data integrity. This role requires the...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Primary Function/General Purpose of Position Under the guidance of the Director, Compliance this position contributes to the Bon Secours Mercy Health mission and vision by serving as a senior auditor of provider revenue cycle compliance. This position provides compliance program-related audit activities relative to Bon Secours Mercy Health operations conducted at local and remote locations and supports provider compliance education and Leadership requests. Conducts specialized compliance investigative audits for Leadership and as part of due diligence to ensure the accuracy and completeness of provider documentation and coding that results in appropriate reimbursement and data integrity and validation of coded information. Essential Job Functions...

Job Description – Coding and Billing Auditor Location: Dover, DE Schedule: Days Job Type: Permanent/Full-Time Salary Range: $53,000.00 to $81,000.00 Position Overview: The Coding and Billing Auditor is responsible for reviewing, analyzing, and auditing professional physician claims to ensure accurate ICD-10 and CPT coding, complete and compliant clinical documentation, and adherence to internal and regulatory standards. This role provides guidance and education to physicians, midlevel providers, coders, and charge entry personnel to improve documentation quality and coding accuracy. The auditor also supports the revenue cycle team and collaborates with leadership to implement process improvements and training initiatives. This is a full-time, onsite position at BayHealth Hospital – Kent Campus in Dover, DE. Key Responsibilities: Perform data quality reviews and audits of provider medical records to validate accuracy of ICD-10 and CPT coding, principal...

Evolent Health Care Job Opportunity Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. We seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the Plans' provider agreements and the National...

Job Description Job Description Hybrid-Sunrise, Florida Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud...

Lead Certified Coding Specialist - Auditor Title: Lead Certified Coding Specialist - Auditor Location: Novant Health Urgent Cares (Columbia, SC) Status: Full-Time Who Are We? Part of the Novant Health family based in North Carolina, Novant Health Urgent Care (formerly Doctors Care) provides exceptional healthcare through our network of more than 50 urgent care centers and 20 physical therapy facilities across South Carolina. Our Columbia-based headquarters delivers non-medical management and administrative services to support these locations. For decades, we have been committed to delivering exceptional, convenient, and affordable healthcare experiences to families and communities throughout the Palmetto State. What Do We Offer? Competitive wages with annual market data review Incentive Pay Program Continuing Education Reimbursement Eligible employer under the Public Service Loan Forgiveness PSLF Program UpToDate Subscription Generous PTO 403(b)...

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

Your Future Evolves Here Evolent is on a mission to transform healthcare for individuals with complex and costly conditions. By collaborating with health plans and providers, we aim to create a more integrated healthcare system that offers high-quality care and compassion, just as we would want for our loved ones. We value work/life balance, offering flexible schedules that allow you to tailor your work to your life. Our commitment to diversity and inclusion ensures that you can bring your whole self to work. Join Evolent not only for the impactful mission but also for a supportive and inclusive culture. What You'll Be Doing: As a Program Integrity Coder and FWA Auditor, you will play a crucial role in ensuring the integrity of claims by reviewing and verifying complex claim submissions for compliance with coding standards and billing guidelines. You will foster meaningful partnerships with both internal and external stakeholders while thriving in a collaborative...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network. Responsibilities A day in the life of an Physician Billing (PB) Coding Auditor and Educator...

Job Description Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Revenue Cycle Revenue Integrit Work Type: Full Time (Total FTE between 0.9 and 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $29.36 - $47.79 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: The Billing Coding Auditor uses advanced knowledge of billing, coding, auditing, documentation requirements, and charge capture to...

Senior Compliance Coding Auditor 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. 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...

Evolent Health Care Program Integrity Coder- FWA Auditor Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in...

Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various...