Coding documentation compliance auditor jobs

Coding & Documentation Compliance Auditor

Hartford HealthCare Enfield, CT

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...

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Coding & Documentation Compliance Auditor

Hartford HealthCare Bridgeport, CT

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...

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Coding & Documentation Compliance Auditor

Hartford HealthCare 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. ·...

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Coding & Documentation Compliance Auditor

Hartford HealthCare at Home 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...

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Coding & Documentation Compliance Auditor

Hartford HealthCare Hartford, CT

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...

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On-Site Coding & Documentation Compliance Auditor

Hartford HealthCare Hartford, CT

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

Full Time

Coding Auditor

University of Utah Health Remote

The position audits and reports on the accuracy of procedural billing, payment consideration and accuracy in reimbursement based on the correct interpretation and application of codes, modifiers and payment rules. The incumbent reviews and audits physician and institutional billing from multiple departments and entities across the organization, and assists in training departmental personnel in correct coding and documentation. This position is not responsible for providing patient care. Responsibilities Essential Functions Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding and billing. Reviews insurance payments for reimbursement accuracy, which is based on correct interpretation of clinical data and application of codes, modifiers and payment rules. Reviews and audits institutional coding and billing from multiple departments and entities across the organization. Assists in training personnel in...

Full Time Part Time

Compliance Coding Auditor and Educator

Gill Compliance Solutions, LLC Remote

Are you passionate about physician coding, compliance, and education? Gill Compliance Solutions is growing, and we're looking for an experienced Audit & Education Manager (remote) to join our nationally recognized consulting team. Our consultants work directly with physician practices, hospitals, health systems, new tech, and legal firms across the country to defend providers, improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new specialties, new challenges, and opportunities to make a measurable impact. If you enjoy educating providers, solving complex coding issues, presenting audit findings to executive leadership, and staying at the forefront of healthcare regulations, we'd love to meet you. Duties may include but are not limited to the following: Managing and performing audits from electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in...

Full Time

Audit and Coding Specialist

Community Reach Center Hybrid (Westminster, CO)

About the role: The Audit and Coding Specialist (“Audit and Coding Specialist”) is an integral member of Community Reach Center’s Quality Improvement (“QI”) Division. The Audit and Coding Specialist is responsible for managing all aspects of assigned projects, reviewing compliance standards to maintain quality assurance functions, and support risk management activities for the agency. Additionally, the Audit and Coding Specialist will have other duties and responsibilities as determined from time to time by the Utilization Manager. Essential Functions: Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP). Conducts audits as determined by the Manager or Director. Oversees...

Full Time

HIM Professional Billing Coding Manager (Hybrid)

El Camino Health Hybrid (Mountain View, CA)

Lead Coding. Drive Revenue Integrity. Shape Provider Performance. El Camino Health is seeking a highly experienced HIM Professional Billing Coding Manager to lead coding operations across its medical network. This is a critical leadership role directly tied to revenue cycle performance, compliance, and provider documentation excellence. If you bring deep expertise in professional billing (PB) coding, auditing, and provider education , this is your opportunity to make a meaningful impact within a respected, nonprofit health system. About El Camino Health El Camino Health is an integrated, nonprofit health system known for delivering high-quality, patient-centered care across its communities. With a strong commitment to innovation, compliance, and clinical excellence, the organization plays a vital role in driving healthcare outcomes and access across the region. This position is onsite in Mountain View, CA 2 days a week, with 3 days available for remote work....

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Lead Medical Coder and Auditor [PR0001D]

ProSidian Consulting Fort Stewart, GA

Lead Medical Coder and Auditor ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian Seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military...

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Medical Coding Auditor

Humana Pierre, SD

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Outpatient Coding Auditor - Surgical Specialty

Sage Clinical RCM, LLC St. Petersburg, FL

Job Description Job Description Description: Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff. Key Responsibilities Perform audits of outpatient surgical encounters, including operative reports and related documentation Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs Ensure compliance with CMS, payer, and official coding guidelines Identify trends, risks, and educational opportunities based on audit findings Provide written audit feedback and coding education to support quality improvement Collaborate with coding leadership and...

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Medical Coding Auditor

Humana Carson City, NV

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Concord, NH

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Cheyenne, WY

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Juneau, AK

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana East Montpelier, VT

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Bismarck, ND

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Frankfort, KY

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Jefferson City, MO

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Remote Inpatient Coding Auditor & ICD-10 Expert

Cognizant Augusta, ME

Cognizant is seeking an Inpatient Medical Coding Auditor to review inpatient records for diagnostic and procedural coding accuracy and compliance. You will verify physician documentation and assign ICD-10-CM/PCS codes using Solventum (3M) per policy and regulatory guidelines, while mentoring clients in coding and compliance. Requirements include CCS/RHIT/RHIA certification, APR DRG experience, at least five years of facility‑based auditing experience, and strong communication skills. #J-18808-Ljbffr

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Medical Coding Auditor

Humana Augusta, ME

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

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Medical Coding Auditor

Humana Helena, MT

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

1451 coding documentation compliance auditor jobs found