1184 clinical records compliance auditor jobs found

Newport News Behavioral Health Center seeks a dedicated Records Coordinator to ensure clinical notes and patient care documentation comply with licensing and DMAS regulations. The role centers on auditing open charts, scanning confidential forms, processing ROI requests, and organizing EMR files. Ideal candidates will have a Bachelor’s degree in a relevant field (or equivalent) with High School Diploma or GED. #J-18808-Ljbffr

Newport News Behavioral Health Center seeks a dedicated Records Coordinator to ensure clinical notes and patient care documentation comply with licensing and DMAS regulations. The role centers on auditing open charts, scanning confidential forms, processing ROI requests, and organizing EMR files. Ideal candidates will have a Bachelor’s degree in a relevant field (or equivalent) with High School Diploma or GED. #J-18808-Ljbffr

Newport News Behavioral Health Center seeks a dedicated Records Coordinator to ensure clinical notes and patient care documentation comply with licensing and DMAS regulations. The role centers on auditing open charts, scanning confidential forms, processing ROI requests, and organizing EMR files. Ideal candidates will have a Bachelor’s degree in a relevant field (or equivalent) with High School Diploma or GED. #J-18808-Ljbffr

Newport News Behavioral Health Center seeks a dedicated Records Coordinator to ensure clinical notes and patient care documentation comply with licensing and DMAS regulations. The role centers on auditing open charts, scanning confidential forms, processing ROI requests, and organizing EMR files. Ideal candidates will have a Bachelor’s degree in a relevant field (or equivalent) with High School Diploma or GED. #J-18808-Ljbffr

Yeo & Yeo Medical Billing & Consulting Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future we provide...

Outpatient Coding Compliance Auditor Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws,...

Job Description Job Description Company Description More Than Just Care, It’s Community   Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.   If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be  Munson Material.  To us, that means teammates who live by our values of  excellence, teamness, positivity, creativity,  and a commitment to creating  exceptional experiences  for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You   Grow:  Tuition reimbursement, in-person and online development, and access to our career hub to...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. The Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position supports the identification of suspected Waste & Error of health insurance claims and ensures claims are accurately documented. Candidates must be able to exercise...

UnitedHealth Group is seeking a Medical Coding Auditor to determine the accuracy of claims by comparing to medical records and to identify waste and errors in a telecommuting role across the U.S. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record reviews. You will review CPT/HCPCS codes, ensure compliance, and produce clinical narratives. Strong data interpretation, communication, and collaboration skills are essential. #J-18808-Ljbffr

Compliance AuditorThe Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons.Essential Functions:Developing compliance auditing plans based on thorough research on studies conducted by government agencies and professional organizations.Conducting, managing, and overseeing external and internal audits for clinical departments.Audit departments and policies for those departments and ensure that all are following said...

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire and...

UnitedHealth Group is seeking a Medical Coding Auditor to assess the accuracy of claims by comparing medical records, with a telecommuting arrangement across the U.S. The role supports compliance, coding policy interpretation, and clinical narrative development for complex payment decisions. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record review, with strong analytical and independent work abilities, in a production-driven environment. #J-18808-Ljbffr

UnitedHealth Group is seeking a Medical Coding Auditor to determine the accuracy of claims by comparing to medical records and to identify waste and errors in a telecommuting role across the U.S. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record reviews. You will review CPT/HCPCS codes, ensure compliance, and produce clinical narratives. Strong data interpretation, communication, and collaboration skills are essential. #J-18808-Ljbffr

Medical Coding AuditorOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.The Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position supports the identification of suspected Waste & Error of health insurance claims and ensures claims are accurately documented. Candidates must be able to...

UnitedHealth Group is seeking a Medical Coding Auditor to assess the accuracy of claims by comparing medical records, with a telecommuting arrangement across the U.S. The role supports compliance, coding policy interpretation, and clinical narrative development for complex payment decisions. The position requires AHIMA or AAPC certification and 2+ years in coding and medical record review, with strong analytical and independent work abilities, in a production-driven environment. #J-18808-Ljbffr

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. The Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position supports the identification of suspected Waste & Error of health insurance claims and ensures claims are accurately documented. Candidates must be able to exercise...

## Compliance AuditorApplylocations: MHC Nashville, TNtime type: Full timeposted on: Posted Todayjob requisition id: JR102201Ranked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee.Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis.If you are interested in joining a team that is caring, collaborative, innovative...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key Responsibilities Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. Ideal Candidate The ideal candidate will have at least...

Coding Auditor Educator - Hospital Coding Vancouver, WA | Administrative/Non-Clinical Support | Full Time PeaceHealth is seeking a Coding Auditor Educator - Hospital Coding for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $34.74 $52.12. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. Job Summary The coding reviewer acts as an expert resource for auditing and training in support of accuracy and appropriateness of coding using ICD-10 and CPT industry standards and PeaceHealth guidelines. Essential Functions Performs coding audits and pre-billing coding compliance functions as required by system regulatory policies/procedures and established review metrics. Participates in development of action plans to include follow up education on identified issues with subsequent audit and reassessment....

Medical Compliance AuditorWe are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical necessity...

Join Our Caring CommunityHumana, a Fortune 100 Company, is looking for an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments.The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records.The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following:Review inpatient medical records and claims to ensure accurate coding and reimbursementAssign and validate ICD-10-CM, ICD-10-PCS, and DRG codesAudit coding quality and identify opportunities for...