353 coding compliance auditor jobs found

Date Posted: 2025-06-25 Country: United States of America Location: Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages. Offering competitive salaries and comprehensive benefits packages to include tuition reimbursement, 401-K match, pet and legal insurance. A LITTLE BIT ABOUT FCS Since 1984, Florida Cancer Specialists & Research Institute & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting-edge technologies, and advanced treatments, we are committed to providing world-class cancer...

Job Summary: HIM Coding auditor/trainer will coordinate, monitor, and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-10, ICD-9- CM, HCPSC codes and clinician documentation to ensure that Kaiser Permanente is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities. The auditor will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, this position will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, Revenue Cycle, External and Internal practitioners, and other regional departments as appropriate including...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Performs all other duties as assigned. Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and...

Job Description I. General Summary Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. II. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for...

Company Description The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org. Job Description I....

Job Description Job Description Company Description The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state’s future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System’s anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit...

Job Description FlexStaff Experienced Compliance Auditor- Full-Time- Hybrid Role- Chappaqua, NY. Exciting Opportunity: Join Our clients as a Compliance Auditor! Are you passionate about healthcare and eager to make a difference in ensuring compliance and excellence in patient care? Our client is seeking a dynamic Compliance Auditor to join this top organization and support their mission of delivering top-tier anesthesia and clinical services. In this pivotal role, you will leverage your healthcare experience-whether as a healthcare coder or in a similar capacity-to conduct comprehensive audits of clinical records, with a special focus on anesthesia documentation and billing accuracy. Your expertise in medical terminology, combined with proficiency in Microsoft Office tools like Word, Excel, PowerPoint, and Outlook, will enable you to analyze data, prepare reports, and communicate findings effectively. As a key member of our compliance team, you will support ongoing...

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Job Summary: The Compliance Auditor position is responsible for supporting the organization's Revenue Management Compliance department in developing, implementing, and administering an effective compliance program. Accurately audits and provides compliance research support to physicians, non-physician practitioners, leadership, and administrative staff on documentation and coding requirements. Determines the adequacy of medical record documentation, coding, and billing, using established compliance auditing and research guidelines for hospital and professional services. Job Duties: Performs compliance audits to determine the adequacy of medical record documentation, billing, and coding, utilizing policies, procedures, Federal and State, laws, regulations, and standard coding guidelines. Evaluates whether...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities May assign and sequence basic CPT (Current Procedural Terminology) procedure codes (non-complex), and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures. Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG)...

Join to apply for the MRA Coder role at Genuine Health Group 1 week ago Be among the first 25 applicants Join to apply for the MRA Coder role at Genuine Health Group Summary The Medicare Risk Adjustment (MRA) Coder plays a critical role in driving risk adjustment accuracy and provider documentation quality across the Genuine Health Group network. Review and audit patient medical records— including histories and physicals, progress notes, diagnostic reports, pathology results, medication, labs results and discharge summaries— to ensure diagnoses are accurately captured, documented, and coded in compliance with CMS risk adjustment standards. Apply MEAT criteria to validate chronic conditions and ensure accurate HCC capture. Conduct comprehensive retrospective chart reviews for each assigned panel twice per year - every semester. Perform pre and post-visit chart audits to support real-time documentation improvement proactively identify coding opportunities. Submit validated HCC codes...

Employment Type:Full timeShift:Day ShiftDescription:Position Purpose: Coding and Compliance Specialist monitors and evaluates coding and documentation of Mount Carmel Health System employed/contracted providers of professional services. Responsible for coordinating and monitoring daily workflow and work assignments of Physician Coding Specialists. Maintains monthly statistical reports to monitor the Physician Coding process and compliance.What You Will Do:Responsible for coordinating and monitoring daily workflow and work assignments of physician Coding Specialists.Responsible for training of Coding Specialists in all areas of responsibility within Physician Coding Services.Conducts quality monitoring of coding completed by Coding Specialists and provides feedback in a constructive manner.Monitors, researches and implements changes in response to all local, state and federal regulations pertaining to the private practice of medicine. Implements changes in response to all local,...

Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Annual Salary Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $68,875.27 Mid = $86,094.08 Max = $103,312.90 Summary: The Compliance Auditor performs proactive and reactive internal and external audits and investigations related to documentation, coding and billing, and regulatory guidelines for hospital and outpatient services. Responsibilities: Performs proactive and reactive internal and external audits and investigations for hospital and outpatient services rendered to ensure proper documentation, medical necessity, accurate coding and billing are supported. Continually monitors regulations, standards and regulatory guidelines in...

Responsible for leading coding teams, coder training, work queue management, performing prebill and second-level coding reviews utilizing auditing tools and applicable software. Uses knowledge of coding and compliance guidelines to identify potential Health, Outpatient, Management, Auditor, Patient, Information, Healthcare

Join Our Team at Skin and Cancer Institute! Are you passionate about dermatology and skin health? Do you thrive in a dynamic, patient-focused environment? Skin and Cancer Institute is looking for dedicated professionals to join our team! Why Join Us? At Skin and Cancer Institute, we are committed to excellence in dermatology, skin cancer treatment, and cosmetic procedures. We offer a supportive and collaborative work culture where your skills and dedication make a real impact. What You’ll Do: The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor partners with practices, providers, and other departmental leaders to provide education regarding medical coding and documentation as required by current CMS regulations. The...

Quality Assurance Nurse Auditor / Nurse Analyst / Coding Auditor PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and outpatient), rehabilitation, and behavioral health services...

Description IntroductionExperience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below:Profee Coding AuditorParallonBenefitsParallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home...

PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a quality assurance and project management role. RESPONSIBILITIES: Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required. The Consultant will assist PYA clients with provider documentation improvement, reviews for billing and other regulatory compliance with third party...

Job Title: Remote HCC Coding Auditor Pay: $24.65 an hr | Bi-weekly Job Type: Remote Shift Options: Mon-Fri 8 am - 5 pm Remote HCC Coding Auditor Overview: The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS. Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies. Remote HCC Coding Auditor Qualifications: 1. Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment 2. Attention to detail and accuracy in retrospective chart reviews 3. Familiarity with CMS coding guidelines and HIPAA-compliant data handling...

A healthcare employer in Houston, TX is seeking a Coding Auditor to join their growing team. This position is remote but candidates must live in the following states: TX, OK, LA, TN, FL, and GA. This position will audit and educate our coders (internal and onsite coders approx.. 40+ coders). The person in this position will audit 80-85% of the time with education to the coders based on auditing results. They will be focused on surgical coding within the following specialties: Urology, Bariatrics, Interventional Cardiology, OB/GYN or General Surgery .We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.About Duke Health's Patient Revenue Management OrganizationPursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.General Description of the Job ClassCoordinate /review the work of vendor outsourcing partners and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM/ICD-10-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement professional...