18 coding documentation compliance auditor jobs found in Hartford, CT

Work where every *moment *matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional,facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: · Conducts audits in accordance with the approved Revenue Compliance Work Plan or as requested by the Manager or Director. ·...

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional , facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: • Conducts audits in accordance with the approved Revenue Compliance Work Plan or as requested by the Manager or...

Coding & Documentation Compliance Auditor Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: Conducts audits in accordance with the approved Revenue Compliance Work...

Coding & Documentation Compliance Auditor Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Coding & Documentation Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Coding & Documentation Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. Responsibilities include but, are not limited to the following: Conducts audits in accordance with the approved Revenue Compliance Work...

Location Detail: 100 Pearl Street Hartford (10484) Shift Detail: Monday-Friday 8:00am-4:30pm Work Location Type: In Person Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. Responsibilities Conducts audits in accordance with the approved Revenue Compliance Work Plan or as requested by the Manager or Director. Maintains organized files to support audit observations and drafts related audit reports in accordance with agreed upon standards in a timely manner. Collaborates with business owner to develop agreed-upon action plans to address findings identified during an audit. Communicates audit results and corrective action plans to audit stakeholders. Monitors progress of corrective actions and provides status reports to leadership. Independently validates...

A comprehensive healthcare network in Hartford, Connecticut is seeking an auditor to conduct compliance audits and collaborate with business owners on corrective actions. Candidates should possess a bachelor's degree and a minimum of two years of health care compliance experience, preferably within a large healthcare system. CPC certification is strongly preferred. The position offers opportunities for career growth and features a competitive benefits program ensuring work/life balance. #J-18808-Ljbffr

CVS Health is seeking a Program Integrity Auditor to review medical, behavioral, transportation and other provider records, ensuring correct coding, documentation, and regulatory compliance. This full-time role involves auditing records, identifying FWA, and coordinating with regulators as needed. Qualifications include 3–5 years of claims data review, CPT/HCPCS/ICD-10 coding experience, and an active CPC/CCS/CPMA license; hours Monday–Friday 8am–5pm Arizona Time. Competitive benefits apply. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified 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 reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Job Summary The Coding Auditor performs coding audits to assure compliance with Corporate Compliance Plan standards. This role develops, coordinates, and implements clinic wide education for coding and billing issues while serving as a resource to physicians, office staff, management and patients for coding and billing issues. Additionally, this role coordinates successful response to regulatory bodies and insurance companies for medical record reviews and audits. Minimum Education High School Diploma or GED. Bachelor’s degree in Healthcare Administration or Business Administration, preferred. Licensure, Registration and/or Certification Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Work Experience Minimum 3 years of hospital or physician auditing experience with 1 year of hospital or physician coding experience. Hierarchical Condition Categories (HCC)...

GeBBS Healthcare Solutions is seeking an experienced Coding Compliance Auditor to join our remote team. You will audit inpatient and outpatient records for accurate ICD-10-CM/PCS, CPT and HCPCS coding, ensuring alignment with CMS and other regulatory guidelines. Responsibilities include identifying trends, producing actionable audit reports, and educating coders and staff to improve documentation quality. A strong background in Medicare reimbursement (MS-DRGs/IPPS/OPPS) and Epic EHR is highly #J-18808-Ljbffr

Job Description Job Description Description: GeBBS Healthcare Solutions Full-Time | Remote Help Shape the Future of Coding Accuracy and Healthcare Compliance Are you passionate about coding integrity, regulatory excellence, and helping healthcare organizations maintain the highest standards? GeBBS Healthcare Solutions is seeking an experienced Coding Compliance Auditor to join our growing team of industry experts. In this role, you'll leverage your extensive coding knowledge to evaluate documentation accuracy, identify compliance risks, and provide meaningful education that improves coding quality across complex healthcare environments. If you enjoy analyzing trends, influencing best practices, and partnering with coding professionals to drive continuous improvement, we'd love to hear from you. What You'll Do Perform comprehensive audits of inpatient and outpatient medical records to validate accurate ICD-10-CM, ICD-10-PCS, CPT,...

Job Description Job Description Description: The Facility Inpatient Coding Auditor is responsible for auditing inpatient facility coding with a focus on OB/NB, CAH, & Rehab auditing, for accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and compliance risk Validate documentation supports coded diagnoses and...

Job Description Job Description Description: Full-Time, Remote Temporary Opportunity with Long-Term Potential The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will audit records to ensure coding accuracy and compliance with CPT/HCPCS, ICD-10, and CMS 1500/UB04 elements. This full-time role requires 3+ years in medical coding or documentation auditing, CPC certification, strong attention to detail, and the ability to communicate findings to investigators and leadership. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Description Job Description Great Employment opportunity for a Certified Professional Coder or Professional Specialist Location: East Hartford, CT; Hybrid Interview: Virtual, 2 rounds. Coding test Hourly pay rate up to $27/hour We are seeking a highly skilled and detail-oriented Certified Professional Coder to join our healthcare coding team. In this vital role, you will be responsible for accurately translating medical diagnoses, procedures, and services into standardized codes used for billing, reimbursement, and statistical purposes. The ideal candidate will possess comprehensive knowledge of medical coding guidelines, anatomy, physiology, and medical terminology, ensuring compliance with industry standards and payer requirements. This position offers an excellent opportunity to contribute to efficient revenue cycle management while supporting high-quality patient care documentation. The Professional Review Specialist analyzes medical services and...

Day Kimball Health is hiring a Certified Professional Coder for the Central Business Office . Location: Putnam, CT. Shift: Days Shift, 40 Hours. Why Choose Day Kimball Health? For nearly 130 years, Day Kimball Health has been the trusted healthcare provider for the Northeastern Connecticut community, offering accessible and compassionate care close to home. As a non‑profit, integrated healthcare provider, we are committed to delivering high‑quality services while maintaining a strong connection with our patients and their families. We value both personal and professional growth and offer a supportive, collaborative environment where you can thrive. Certified Professional Coder Job Summary Under the general supervision of the Director of Professional Revenue Cycle, the Certified Professional Coder performs all phases of abstracting, diagnosis coding, charge capture, and posting through record analysis. The coder conducts quarterly chart audits to ensure documentation meets...

Day Kimball Health is hiring a Certified Professional Coder for the Central Business Office ! Location: Putnam, CT | Shift: Days Shift, 40 Hours Job Summary Under the general supervision of the Director of Professional Revenue Cycle, the Certified Professional Coder performs all phases of abstracting, diagnosis coding, charge capture and posting through record analysis. Will perform quarterly chart audits to ensure documentation meets ICD-9 as well as ICD-10 guidelines. Additionally, the Certified Professional Coder will provide ICD-10 training for Providers and staff as needed and will be an integral part of the implementation team. Key Responsibilities Review medical records for completeness and compliance with coding guidelines to abstract and code clinical data, including diseases, operations, procedures, and therapies, using standard classification systems. Review and enter all charges for practice billing from medical record documentation to ensure billed services...