1160 compliance analyst jobs found

Join to apply for the Compliance Auditor Analyst role at Upstate Medical University 5 months ago Be among the first 25 applicants Join to apply for the Compliance Auditor Analyst role at Upstate Medical University Get AI-powered advice on this job and more exclusive features. Job Summary Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong...

The AI Audit Analyst is responsible for conducting risk assessments, reviews, special projects, and other activities on Artificial Intelligence (AI) solutions for the enterprise, across all lines of business and functions, to ensure Elevance Health develops and deploys AI technologies consistent with our internal standards, policies, contracts, laws, and regulations. This position is an exciting opportunity to provide valuable insights to the AI business to improve the effectiveness of risk management, monitoring, and governance processes. How you will make an impact: Assists the development and execution of high-quality risk assessments of AI solutions. Perform reviews of AI solutions, testing for compliance to Elevance Health standards, policies, and regulations. Identify risks and collaborate with AI system team leadership and business management on testing and evaluation procedures, which includes working with the AI business on process, controls, documentation, and...

Apex Systems in the United States is seeking a Compliance Analyst to support Bank Secrecy Act compliance. This role analyzes patron transactions and data from multiple software systems to ensure Currency Transaction Reports and Suspicious Activity Reports are identified and e-filed with FinCEN within required timeframes. Responsibilities include auditing Title 31 policy adherence, verifying document accuracy, and escalating any non-compliance to the Senior Compliance Analyst. #J-18808-Ljbffr

Home Franchise Concepts is seeking a Compliance Analyst in Flower Mound, TX, reporting to the Director of Compliance. The role supports a multi-brand franchise system by conducting systemwide audits, evaluating operational compliance, and guiding franchisees to implement corrective actions to protect brand integrity. The position collaborates with Operations, Finance, and Training to promote standards, mitigate risks, and maintain strong franchisor-franchisee relationships. #J-18808-Ljbffr

A leading staffing and IT solutions provider is seeking a Compliance Analyst for a 6-month contract in Tampa, FL. The role involves coordinating government and compliance documents, analyzing complex issues, and developing risk mitigation strategies. Ideal candidates will have 2-3 years of experience in risk management, a strong audit background in financial institutions, and exceptional communication skills. This position offers a competitive hourly rate of $34 to $36. #J-18808-Ljbffr

Five Rivers IT, Inc in Fair Lawn is seeking a Senior IT Security Compliance Analyst to lead audits and manage compliance initiatives for a diverse client base. This full-time role focuses on governance, risk, and compliance, offering competitive compensation ranging from $125,000 to $175,000. The ideal candidate will have a Bachelor's degree and over 5 years of experience in Information Security audits. Benefits include medical, dental, vision insurance, and a supportive environment for professional certification. #J-18808-Ljbffr

Compliance Auditor needed! Join our growing organization! Onco360 has an immediate need for a Compliance Auditor. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting Salary at $60,000 and up, depending on experience Summary The Compliance Auditor will assist the Onco360/CareMed/ConnectMed360 Compliance Team through the completion of routine and random pharmacy compliance audits at Onco360/CareMed/ConnectMed360 pharmacy locations to ensure all pharmacy activities and operations are executed in compliance with state and/or federal regulations and laws governing pharmacy operations. This individual provides support to Onco360/CareMed/ConnectMed360 pharmacy operations teams in answering compliance and regulatory questions based around their needs. The Compliance Auditor shall develop and provide regular reports and updates regarding compliance matters to the...

Mercy Hospital of Buffalo is seeking a Health Information Management coder to code inpatient, SNF, and rehab records for accurate reimbursement. You will query physicians when documentation is unclear and review records for completeness to ensure compliance with federal regulations. Responsibilities include coding using ICD-10-CM and CPT, collaborating with CDI team members, and maintaining AHIMA CE requirements to stay credentialed. #J-18808-Ljbffr

Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and/or reviewing medical record documentation to assign and sequence diagnoses and procedure codes according to coding guidelines, and enter into the electronic system: a. Appropriate diagnoses codes, professional service codes and modifiers and/or facility service/ charge codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules. Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures. Accrues sufficient continuing education hours to maintain national coding certification. Serves as a resource...

Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and/or reviewing medical record documentation to assign and sequence diagnoses and procedure codes according to coding guidelines, and enter into the electronic system: a. Appropriate diagnoses codes, professional service codes and modifiers and/or facility service/ charge codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules. Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures. Accrues sufficient continuing education hours to maintain national coding certification....

Department Information This position is open to current Colorado residents only Please note: This recruitment may be used to fill multiple vacancies. Work Unit The Public Assistance Quality Assurance (PAQA) unit exists to: Administer the federally mandated state “Quality Control System” that enhances payment accuracy and improve program administration including measuring program accuracy, assessment and resolution of potential liabilities, policy development, and formulating improvement plans; Provide independent third-party review and quality improvement processes for the Supplemental Nutrition Assistance Program (SNAP) including case file audits, data collection, analysis and reporting on findings, providing technical and compliance training to county workers, assess and measure county adherence to state and federal regulations; and Create strong partnerships with state and county staff to provide additional services such as non-quality assurance case reviews and consulting,...

Actalent in Fort Atkinson, WI seeks a Quality Assurance Analyst to ensure production and sanitation meet USDA and FDA standards. You will audit processes, collect samples, and verify packaging and operating practices to maintain quality. Responsibilities include reporting, holding nonconforming product, and supporting HACCP/GMP compliance while collaborating with production and sanitation teams to drive corrective actions. #J-18808-Ljbffr

Senior Medical Coding AnalystCodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care.Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Remote Chicago - 550 Van Buren North Carolina Nevada Virginia Texas Florida Maryland Tennessee New York-New York City Wyoming Idaho Massachusetts Michigan-Other West Virginia-Other Nebraska Maine West Virginia-Charleston Washington-Seattle Wisconsin Pennsylvania-Pittsburgh Colorado-Denver California-San Francisco Vermont Delaware-Wilmington Iowa Ohio-Other District of Columbia Georgia Missouri-St. Louis New Hampshire Indiana-Other Mississippi Pennsylvania-Philadelphia Minnesota Arkansas Utah Missouri-Kansas City Kentucky-Other Michigan-Detroit New Jersey Montana California-Los Angeles Alabama-Other New Mexico North Dakota South Carolina Rhode Island Full time JR-0015943 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,...

Senior Inpatient Medical Coder/Acute Edits And Denials Claims Analyst 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Senior Inpatient Medical Coder/Acute Edits and Denials Claims Analyst, you will work remotely to correct, CCI, Medically Unlikely (MUE) Edits, and Medical Necessity Edits in addition to periodic coding. You will also work combine 3 day payment window, denial claim edit, dental and various other WQ accounts. You will...

Inpatient Coding Auditor 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...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meetsand exceedsour customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Remote Chicago - 550 Van Buren North Carolina Nevada Virginia Texas Florida Maryland Tennessee New York-New York City Wyoming Idaho Massachusetts Michigan-Other West Virginia-Other Nebraska Maine West Virginia-Charleston Washington-Seattle Wisconsin Pennsylvania-Pittsburgh Colorado-Denver California-San Francisco Vermont Delaware-Wilmington Iowa Ohio-Other District of Columbia Georgia Missouri-St. Louis New Hampshire Indiana-Other Mississippi Pennsylvania-Philadelphia Minnesota Arkansas Utah Missouri-Kansas City Kentucky-Other Michigan-Detroit New Jersey Montana California-Los Angeles Alabama-Other New Mexico North Dakota South Carolina Rhode Island Full time JR-0015943 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,...

Job Description HIM Coder Analyst II LOCATION Fort Worth, Texas | Onsite COMPENSATION & SCHEDULE Pay: $35.00-$40.00/hour Schedule: Full-time Employment Type: W2 ROLE IMPACT Support accurate reimbursement, regulatory compliance, and quality reporting by reviewing outpatient medical records and assigning accurate ICD-10-CM and CPT-4 codes. Success in this role is measured by coding accuracy, productivity, effective provider communication, and adherence to coding guidelines and documentation standards. KEY RESPONSIBILITIES Review and interpret outpatient medical records to assign ICD-10-CM and CPT-4 codes with the highest level of specificity for ambulatory surgery, observation, special procedures, emergency department, ancillary, and clinic encounters. Code primarily complex ambulatory surgery and observation cases while maintaining a minimum coding accuracy rate of 95%. Abstract required clinical and demographic information into the electronic health record to support...

At Garnet Health, the Hudson Valley’s leading integrated health system, you’ll find the perfect balance of a satisfying career and a rewarding lifestyle. Our focus is on patient-centric care with a collective of visionary leaders and dedicated and caring professionals working as a team to deliver the best for the people we serve. If you’re interested in a health system that’s both growing and award-winning, serving a diverse community that provides the best of both city and rural life, we invite you to make your career home with us as a Coding Denials Analyst on our Coding team at/in Garnet Health Medical Center. Join the Garnet Health team and let your excellence shine. Responsibilities Reporting to the Administrator, Revenue Cycle, this individual is responsible for the oversight, analysis, and management of coding and DRG denial data across the health system. The Analyst supports accurate reimbursement and compliance by manually collecting, organizing, and analyzing denial...

Medical Technologist Supervisor (Notional Opportunity) 3 months ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Our vision aims to empower our clients by actively leveraging our broad range of services. With our global presence, we have career opportunities all across the world which can lead to a unique, exciting and fulfilling career path. Pick your path today! To see what career opportunities we have available, explore below to find your next career! Please be aware of employment scams where hackers pose as legitimate companies and recruiters to obtain personal information from job seekers. Please be vigilant and verify the authenticity of any job offers or communications. We will never request sensitive information such as Social Security numbers or bank details during the initial stages of the recruitment process. If you suspect fraudulent activity, contact us directly through our official channels. Stay safe and protect...

A healthcare organization in New Mexico is seeking a remote Medical Coding Analyst I or II. This role focuses on coding inpatient and outpatient services, ensuring compliance with federal regulations while providing feedback on medical documentation. Candidates must have a high school diploma or GED and relevant certification in coding. The position offers a competitive salary, a sign-on bonus of $2,000, and comprehensive benefits, fostering well-being across New Mexico. #J-18808-Ljbffr

The University of New Mexico is hiring a detail-oriented Medical Coding Analyst for its Student Health & Counseling Clinic. In this full-time role, the analyst will coordinate fee processing for patient services, ensuring compliance with legal and procedural requirements. The position offers a pay range of $24.00 to $30.00 per hour based on experience and includes benefits such as medical, dental, vision, and life insurance. Applicants should have a high school diploma or GED and at least one year of relevant experience. Preferred qualifications include experience in medical coding and working with insurance claims. #J-18808-Ljbffr

Certified Professional Coder- Medical Biller Certified Professional Coder- Medical Biller 2 days ago Be among the first 25 applicants Women's Health Connecticut provided pay range This range is provided by Women's Health Connecticut. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $27.00/hr - $29.00/hr Direct message the job poster from Women's Health Connecticut Talent Acquisition Specialist II at Women's Health Connecticut Women’s Health Connecticut is seeking to hire a Full-time, Certified Professional Coder (CPC)- Medical Biller at our corporate business office in Rocky Hill, CT. Position : Certified Professional Coder (CPC)- Medical Biller Location : Women's Health CT- HQ Working arrangement : Hybrid, 2-3 days per week in-office Employment Type : Full-time, 40 hours per week Schedule : Monday- Friday Reports to : Director of Revenue Cycle Management Position Summary: The CPC-Medical Biller is responsible for...