1035 clinical compliance auditor jobs found

Senior Clinical Compliance Auditor page is loaded## Senior Clinical Compliance Auditorlocations: Flowood, MStime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100294# Healthy Careers Start HereAt Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle.# 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...

A leading health insurance provider in Mississippi is seeking a Senior Clinical Compliance Auditor. This role involves reviewing clinical data, coordinating and validating billing practices for healthcare providers, and working closely with various teams. Required qualifications include a Bachelor's degree in Nursing and at least three years of relevant experience. The ideal candidate will possess strong communication, organizational, and analytical skills. Join us to promote health and wellness throughout Mississippi. #J-18808-Ljbffr

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Non-Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with...

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership...

A leading global eye care company is seeking a Good Clinical Practices Auditor in Durham, NC. The successful candidate will conduct and supervise audits, ensure compliance, and mentor junior auditors. A Bachelor’s Degree and at least 2 years of relevant experience are required. This role offers competitive compensation with a salary range of $75,000 to $125,000. Join a committed team and thrive in a culture that values innovation and quality. #J-18808-Ljbffr

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Non-Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen...

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Auditor (Clinical) Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen...

A leading cancer research institution in Tampa is seeking a Research Compliance Quality Auditor II. Responsibilities include conducting audits of clinical research for compliance, managing corrective action plans, and developing training materials. The ideal candidate should have a Bachelor's degree in a relevant field, an LPN/RN license, or equivalent experience in GCP auditing with at least four years in a quality research environment. This position offers a full-time schedule with working hours of 8 am to 5 pm from Monday to Friday. #J-18808-Ljbffr

A healthcare provider in Baltimore is seeking a Clinical Coding Specialist to audit medical records and ensure proper coding for reimbursement and compliance. The ideal candidate should have a high school diploma, formal coding training, and relevant certifications. You'll work with clinical staff to address documentation issues and audit complex inpatient cases. Strong analytical and organizational skills are essential for this role, alongside excellent customer service capabilities. #J-18808-Ljbffr

A healthcare organization in Baltimore is seeking a clinical coding expert to audit hospital visits and ensure compliance with coding regulations. Responsibilities include analyzing documentation, auditing ICD-10 codes, and consulting with medical staff. Candidates must have a high school diploma or related certification, with a minimum of two years coding experience in a hospital setting. Pay ranges from $36.61 to $45.71 per hour, based on experience. #J-18808-Ljbffr

Inpatient Medical Coding Auditor Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing...

Inpatient Medical Coding Auditor Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing...

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...

divh2Inpatient Medical Coding Auditor/h2pBecome a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment./ppIf you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Job Description Job Description Job Title: Professional Coding Auditor (CPC Required) Location: Dover, DE 19901 (Onsite) Salary Range: $53,000 – $81,000 (Facility Salary Range) Employment Type: Full-Time If interested, please email your resume to LKOPASZ@ALINESTAFFING.com Certified Professional Coder (CPC) Position Overview Seeking a Certified Professional Coder (CPC) with strong physician (professional) coding experience in a medical office setting. This role focuses on coding audits, documentation quality reviews, and provider education. The ideal candidate has experience coding across multiple specialties and regularly collaborates with physicians to provide documentation feedback and compliance education. Auditing experience is preferred. Certified Professional Coder (CPC) General Summary Performs data quality reviews on provider documentation to validate ICD-10-CM and CPT coding accuracy and clinical documentation integrity. Audits...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Summary The Medical Records Technician (Coder) Auditor is located in the Health Information Management (HIM) section of Medical Administration Service at the VA Maryland Health Care System. A Medical Records Technician must possess expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), the Healthcare Common Procedure Coding System (HCPCS) and be skilled in classifying medical data from patient health records. Responsibilities Total Rewards of a Allied Health Professional Duties: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural...

Medical Records Technician (Coder) Auditor This position is in the Health Information Management (HIM) section at the Durham VA Health Care System. The Medical Record Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. The duties of the Auditor will include, but are not limited to: Serves as expert of current coding conventions and regulations related to professional and facility coding. Performs audits of encounters to identify areas of non-compliance in coding. Provides recommendations on appropriate coding and is responsible for maintaining current knowledge of the various regulatory guidelines and requirements. Works with staff to ensure that regulations are met or areas of weakness are identified and reported to appropriate supervisor for corrective actions. Performs prospective coding audits and utilizes results to identify processing...

If you have a passion for compliance auditing and a drive for operational excellence, join our growing Quality team as a Compliance Auditor and take your career to the next level at Labcorp. We are seeking an experienced member to join our Quality Assurance team. The Compliance Auditor plays a pivotal role in ensuring that clinical research laboratory testing operations comply with global regulatory standards and industry-recognized best practices, including GCP/GLP, ISO 15189, and ISO 13485. This position leads the internal audit program execution, drives process improvements, collaborates with management to implement audit strategies, mentors junior auditors, and collaborates with cross-functional teams to uphold quality and regulatory integrity across clinical laboratory testing and operational environments. The ideal candidate will possess strong leadership skills, a keen eye for detail, and the ability to oversee complex audit functions in a fast-paced environment with...

Compliance Auditor If you have a passion for compliance auditing and a drive for operational excellence, join our growing Quality team as a Compliance Auditor and take your career to the next level at Labcorp. This is an Onsite position at 8211 Scicor Drive, Indianapolis, IN. Imagine being involved in innovation and projects that change the course of our industry daily! At Labcorp, one of the world's largest and most comprehensive pharmaceutical solutions service companies, you will have an opportunity to build an exciting career while you make a direct impact on the lives of millions. Job Summary: We are seeking an experienced member to join our Quality Assurance team. The Compliance Auditor plays a pivotal role in ensuring that clinical research laboratory testing operations comply with global regulatory standards and industry-recognized best practices, including GCP/GLP, ISO 15189, and ISO 13485. This position leads the internal audit program execution, drives process...