42 clinical compliance auditor jobs found in Los Angeles, CA

Clinical Compliance Auditor We're partnering with an innovative client in the biotechnology industry, and they're looking for a talented Clinical Compliance Auditor to join their dynamic team! If you're passionate about ensuring the highest standards in clinical trials and want to make a real impact, this is the opportunity for you. Don't waitapply today and take the next step in your career. Salary: $100,000-$150,000 Location: Remote Responsibilities: Oversee and regularly update the Clinical Trial Quality Management system to ensure alignment with current industry standards, guidelines, and best practices. Assist in the creation and evaluation of standard operating procedures (SOPs) and other essential controlled documents, such as forms, templates, and work instructions. Ensure adherence to SOPs and compliance with relevant standards, including ICH GCP E6 (R2). Lead the incident management process by tracking and addressing complaints, deviations, and corrective actions...

An innovative biotechnology firm is seeking a Clinical Compliance Auditor to ensure high standards in clinical trials. This remote role involves overseeing quality management systems, creating standard operating procedures, and leading audit processes. Candidates must have a Bachelor's or Master's degree in life sciences or engineering and 4-7 years of experience in the field. Strong auditing skills and relevant certifications are a plus. This position offers a competitive salary of $100,000-$150,000. #J-18808-Ljbffr

Clinical Compliance Auditor Clinical Los Angeles, CA, US Salary: $100,000-$150,000 Location: Remote We're partnering with an innovative client in the biotechnology industry, and they're on the lookout for a talented Clinical Compliance Auditor to join their dynamic team! If you're passionate about ensuring the highest standards in clinical trials and want to make a real impact, this is the opportunity for you. Don’t wait—apply today and take the next step in your career Responsibilities: Oversee and regularly update the Clinical Trial Quality Management system to ensure alignment with current industry standards, guidelines, and best practices. Assist in the creation and evaluation of standard operating procedures (SOPs) and other essential controlled documents, such as forms, templates, and work instructions. Ensure adherence to SOPs and compliance with relevant standards, including ICH GCP E6 (R2). Lead the incident management process by tracking and addressing...

Job Description Job Description WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits...

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

Clinical Coding Auditor & Trainer Location: Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations. Key Responsibilities: Conduct thorough reviews of medical records for compliance with coding regulations Provide feedback and education to coders and physicians to improve coding accuracy and documentation Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries Support ongoing program development through training initiatives and process improvements Deliver coding presentations to diverse audiences, including physicians May supervise departmental staff as needed Qualifications: Minimum...

Salary : $101,536.34 - $139,533.58 Annually Location : Riverside Job Type: Regular Job Number: 25-74191-01 AL Department: RUHS-Medical Center Opening Date: 09/09/2025 Closing Date: Continuous ABOUT THE POSITION Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations. Key Responsibilities: Conduct thorough reviews of medical records for compliance with coding regulations Provide feedback and education to coders and physicians to improve coding accuracy and documentation Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries...

WHO WE ARE AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: Patient-Centered Value Employees Respect for Diversity Nimble Fight for What’s Right Please review our Advocacy page for the latest news on how AHF is Fighting for...

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

Job Description Job Description Job Description Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is in-person at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead the training and mentorship of new...

Job Description Job Description Position Purpose: The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities: Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy....

Description The Departments of Obstetrics & Gynecology, Surgery, and Urology at UCLA seek to hire a Controls and Compliance Auditor. The Controls and Compliance Auditor is an important member of the departmental administrative team, reporting to the Director of Business Analytics & Quality Improvement. in this role you will be the subject-matter expert on UCLA’s Distributed Administrative Computing Security System (DACSS) and associated systems. You will also provide oversight and support in the daily operations of internal controls for a variety of accounting cycles including financial reporting, travel and entertainment, and revenue. Pay Range: $78,500.00 - $163,600.00 annually. #J-18808-Ljbffr

Job Summary: Leads the development of applicable policies and procedures for audit and process improvement projects. Identifies an appropriate plan for correcting deviations from expected quality control results. Promotes the use of strategies to ensure that tests are performed properly and results are verified before being shared. Monitors the management of specimens to ensure they are collected and processed according to established time and quality standards. Removes obstacles that prevent adherence to all requirements related to the recruitment, processing, testing, storage, and distribution of materials and samples. Researches, reports, and responds to technical and/or non-technical deficiencies in regulatory/accreditation inspection processes. Implements new testing methodologies, processes, and technology that have the potential to improve service, quality and/or efficiency. Leads the development and implementation of technical and/or non-technical training materials...

Description Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: * Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre-delegation reviews, and...

Job Summary As a Registered Nurse/Clinical Supervisor I, you'll play a vital role in leading staff in delivering safe patient care. This role functions as a clinical expert, resource, and role model for customer service. The Clinical Supervisor is responsible for adjusting shift schedules, facilitating patient throughput, and staff workflow to meet patient care needs. Critical thinking, effective communication, and collaboration with patients, families, staff, and physicians are essential to achieving care goals and desired outcomes. Education Bachelor of Science degree in Nursing required Licenses and Certifications Current licensure with the California Board of Registered Nursing Must successfully complete and maintain BLS certification. Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment RNC preferred in specialty area(s). Active involvement as a leader/participant in a...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Medical Coder Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. 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...

Contract Assignment Healthcare System (Epic Ehr) This is a remote position. We're seeking a Certified Professional Coder (CPC) with hands-on front-end Epic operational experience to support a health system's day-to-day coding workflows. This contractor will perform professional coding activities directly within Epic's end-user workflows (e.g., encounter completion, charge entry, charge review workqueues) to ensure accurate, timely, and compliant coding and charge capture. Responsibilities: Review clinical documentation and assign CPT/HCPCS, ICD-10-CM codes within Epic at the point of coding (front end), ensuring compliance with payer guidelines and health system policies. Work in Epic workqueues (e.g., Charge Review, Claim Edit, Coding WQs) to resolve edits, denials, and holds; clear daily queues to meet turnaround goals. Validate medical necessity and modifier usage; correct charge router/charge session issues before billing. Collaborate with revenue cycle, clinic...

Inpatient Coding Specialist In accordance with current federal coding compliance regulations and guidelines, use current ICD-10-CM/PCS, CPT-4, and HCPCS code sets/systems to accurately abstract, code, and electronically record into the 3M Coding & Reimburse System (3M-CRS) & the coding abstracting system (3M-ClinTrac), all diagnoses, surgical procedures, and other significant invasive and non-invasive procedures documented by any physician in any inpatient medical records (i.e. Medicare, non-Medicare, and all complex cases). Meet the productivity and accuracy/quality standards. Initiates appropriate clinical documentation querying CDI Specialists in order to acquire or clarify necessary medical record documentation needed to facilitate accurate and complete coding & abstracting. Understands PFS coding/billing processes & systems such as PBAR and nThrive/MedAssets/XClaim in a manner to assure claims drop timely with appropriate codes. Perform other coding...

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

A leading healthcare provider in Los Angeles is seeking a Compliance Auditor to support CMS compliance and conduct crucial audits for Medicare Advantage programs. The role involves collaborating with teams, preparing audit findings, and ensuring organizational readiness for regulatory requirements. Candidates should possess a strong background in compliance auditing and risk assessment. This position offers a competitive salary in a vibrant healthcare environment. #J-18808-Ljbffr

Description Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk‑based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization’s audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre‑delegation reviews, and more....