38 coding compliance auditor jobs found in Los Angeles, CA

Coding Compliance AuditorIn 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...

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 such as Cerner, MediTech,...

Keck Medicine of USC in Los Angeles is seeking a Coding Compliance Auditor to perform 2nd level reviews of coded accounts, ensuring CPT, ICD-10-CM, and HCPCS accuracy with proper documentation support. You will generate audit reports, analytics, and education materials to improve compliance. Under general supervision, you will maintain productivity, respond to inquiries, and assist in clean claim releases using Cerner, MediTech, Epic, and Athena IDX. #J-18808-Ljbffr

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 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. The ideal candidate will have at least five years of progressive experience...

Cedars-Sinai in Los Angeles is seeking a Physician Compliance Auditor to review claims, medical records, and charges for compliance with documentation, coding, and billing rules. You will educate providers and staff, deliver audit results via Teams or other remote meetings, and act as a subject matter expert on coding and documentation guidelines.This role collaborates with the Manager of Audit and Compliance to identify risks, present findings to leaders, and maintain accurate audit records,J-18808-Ljbffr

Job DescriptionAlign with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. We provide an outstanding benefit package that includes paid vacation, wellness initiatives and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals.What you will be doing in this role:The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with providers and staff to educate and train or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with...

Cedars-Sinai in Los Angeles is seeking a Coding Auditor to review encounters in prebill or retrospective workflows and validate coding profiles for accuracy and compliance with AHA, AMA, and related guidelines. The role includes producing summary findings, leading feedback sessions, and coordinating with Coding Operations, CDI, PRM, and CRI to improve data quality and reimbursement outcomes. #J-18808-Ljbffr

Kaiser Permanente is seeking a Compliance Specialist focused on coding functions within all settings of care to ensure alignment with national coding policies and procedures. You will assist with audit readiness, develop compliant documentation, and support regional leadership with findings and corrective actions. You will partner with operational, clinical, and compliance teams to sustain regulatory adherence, drive quality improvements, and maintain the KP code of conduct across all lines of #J-18808-Ljbffr

Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Location: Los Angeles, California, United StatesCompany: Children's Hospital Los AngelesPosted: Coding AuditorLocations:Los Angeles, CaliforniaJob Category:Administrative / ClericalPosition Type:Full-TimeShift:DaysJob...

YO AI Labs is seeking a Medical Auditor contractor to contribute expert coding and auditing skills to our healthcare AI initiative. You will review outpatient professional fee coding records, assess accuracy, compliance, and quality, and help train AI systems with your clinical insight. Ideal candidates bring 10+ years in medical coding with outpatient focus, academic medical center experience, and a proven ability to document findings clearly for cross-functional teams. #J-18808-Ljbffr

Overview The HIM Coding Specialist II is required to have a full understanding and active participation in fulfilling the mission, vision and values of San Gabriel Valley Medical Center. The employee shall support San Gabriel Valley Medical Center's strategic plan and the goals and direction of the department Performance Improvement Plan (PIP). The HIM Coding Specialist II is required to ensure that all patient records are coded within the bill-hold limits (4 days). HIM Coding Specialist II is further responsible to ensure that all charts pass the SMART cycle and are adjusted as needed. The HIM Coding Specialist II must have a comprehensive knowledge of ICD-10-CM, ICD-10 PCS, CPT conventions in accordance with Official Guidelines for Coding and Reporting. The HIM Coding Specialist II is responsible for abstracting data into Evident/Thrive system using 3M encoder. Furthermore, the HIM Coding Specialist II will work internally and externally with coding staff, HIM director and...

Job Details Location: Huntington Beach Office, Huntington Beach, CA 92647. Position Type: Full Time. Salary Range: $72,800.00 – $80,000.00. This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. This role reviews medical record documentation and ICD-10-CM diagnosis coding to ensure compliance with CMS Risk Adjustment program requirements, Official Coding Guidelines, AHA Coding Clinic guidance, and organizational policies. Functions & Responsibilities Conduct retrospective, prospective, and targeted coding audits to assess the accuracy, completeness, and compliance of ICD-10-CM diagnosis coding and HCC capture....

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Coder IIOur client, a healthcare company, is looking for a Coder II for their Costa Mesa, CA location.Responsibilities:The coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verify that all ICD-10-CM codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Coding - client Clinic: In addition to the above, the coder meets ongoing productivity and quality standard of...

UCI Health is seeking an Outpatient Coding Auditor who reports to the Outpatient Coding Manager. You will conduct rigorous departmental and interdepartmental coding audits to ensure compliance with Federal and State regulations and identify discrepancies in acute care outpatient services. You will review records, discuss findings with physicians and staff, provide feedback and education, help develop policies, and stay current with CPT, HCPCS, ICD-10-CM and outpatient regulations. #J-18808-Ljbffr

Benefits Employee discounts Training & development Wellness resources Role Overview Own the end-to-end medical billing lifecycle for a multi-specialty healthcare clinic. Drive clean claims, fast reimbursements, and zero leakage. This is an execution-heavy, accountability-driven role—not a passive billing position. Core Responsibilities Manage full-cycle billing: charge entry, claim submission, payment posting, and follow-up. Bill and reconcile across multiple payor types: Commercial insurance Medicare Personal injury (PI) Workers’ compensation Cash-based services Ensure accurate CPT, ICD-10, and modifier usage across: Medical Chiropractic Physical therapy Acupuncture Massage therapy Aggressively work A/R: Identify denials, underpayments, and delays. Execute timely appeals and corrections. Maintain compliance with: Medicare rules State and federal billing regulations Payor-specific policies Communicate clearly with: Front office Providers...

Job TitleDuties included but are not limited to: 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 Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or evaluation and management (E/M) code to ensure ethical, accurate, and complete coding. Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients under the Veterans Equitable Resource Allocation (VERA) program...

Billing Specialist - Leading TX Center for over 40 years This Jobot Job is hosted by: Jamal Elkhateib Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $23 - $28 per hour A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, weve helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal...

Job Description Job Description All for Health, Health for All, Inc. (AFH) is a nonprofit Federally Qualified Health Center (FQHC) and a certified Patient-Centered Medical Home. For over 40 years, we have provided high-quality, accessible healthcare services to medically underserved and diverse populations across Los Angeles County, Orange County, and the state of Nevada. Our integrated, team-based model includes general family practice, pediatrics, behavioral health, mental health services, and adult day health care. In the past year alone, we served over 30,000 patients across more than 90,000 visits at a dozen clinic locations. AFH is currently seeking dedicated and compassionate individuals to join our mission-driven team. We are hiring Full-Time medical biller/collector. SUMMARY An individual must be able to perform each essential duty satisfactorily which includes billing, posting payments, answering patient questions and concerns by phone or personally in fast-paced,...

Certified Risk Coder Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Compensation: $56,000 - $85,000 / year Description The Certified Risk Coder plays a critical role in supporting Astrana Health's value-based care and risk adjustment initiatives by ensuring the accurate capture and validation of diagnoses through comprehensive medical record review and coding analysis. This position partners closely with providers and clinical teams to improve documentation quality, coding accuracy, and compliance with CMS risk adjustment guidelines. The ideal candidate brings strong coding expertise, a passion for provider education, and a commitment to enhancing organizational performance through accurate risk capture, regulatory compliance, and continuous process improvement. What You'll Do Review medical records and provider documentation to ensure accurate capture of risk-adjusting...

San Gabriel Valley Medical Center is seeking a HIM Coding Specialist II to ensure accurate ICD-10-CM/PCS coding, chart abstraction in Evident/Thrive, and timely completion within bill hold limits. The role collaborates with the HIM Director, coders, and external auditors to maintain coding quality and privacy compliance. Experience in hospital HIM coding and AHIMA credentials are highly valued; patient information must be protected per HIPAA regulations. #J-18808-Ljbffr

Kaiser Permanente is seeking a Compliance Consultant IV, Medical Coding to independently review inpatient, outpatient, professional, and supplemental records to assign ICD-10-CM codes and related risk adjustment categories. The role ensures documentation supports coding and aligns with official guidelines, regulations, and policies. The position emphasizes collaboration with internal and external stakeholders to develop audit reports, monitor compliance, and elevate regulatory concerns, while #J-18808-Ljbffr

Medical Billing Specialist If you think you are the right match for the following opportunity, apply after reading the complete description. Location: Long Beach, CA Pay: $27.00 – $31.00 /hr Schedule: Monday–Friday Hours: 9:00 AM – 5:00 PM Job Type: Full-Time About the Opportunity We're partnering with a well-established outpatient healthcare clinic to find a detail-oriented Medical Billing Specialist to join their revenue cycle team. This organization is known for its patient-centered, inclusive approach to care and its commitment to serving the communities it operates in. This is a great opportunity for a billing professional who thrives in a fast-paced clinical environment and wants to make a direct impact on the financial health of a mission-driven healthcare organization. What You'll Do: Medical Billing & Revenue Cycle Submit insurance claims accurately and on time Review, correct, and resubmit denied or rejected claims Monitor accounts receivable and follow up on...