695 compliance analyst jobs found

Job Description Job Description Are you the missing piece in protecting America’s safety net? We don’t just hire talent—we build purpose-driven teams. At ERN Enterprises, we stand in the gap for emergency safety net providers and the patients they serve. We hold health plans accountable. We speak up for those who can’t, and we’re looking for more than just a resume—we’re looking for you. ERN in the news: https://youtu.be/mw1TQhVFBKk The Mission Our Healthcare Claims Compliance Auditors are warriors for justice in Revenue Cycle Management. You’ll analyze unfair trends, initiate corrective actions, support prelitigation strategy, and make sure regulatory timelines are honored—not ignored. You’ll change lives and challenge systems. Do You Belong Here? We’re looking for people with: Competency – Do you have the skills or the hunger to learn them? Character – Are you ethical, reliable, and honest—even when no one’s watching? Chemistry – Can you collaborate, communicate,...

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 computer skills specifically Microsoft word and Microsoft excel applications. Strong analytical, problem-solving and time management skills. Expertise in report writing and oral communications. Ability to interpret regulations, payment and reimbursement systems, billing and...

Job Description Job Description "All candidates must be directly contracted by ASK Consulting on their payroll and cannot be subcontracted. We are unable to provide sponsorship at this moment". Job Title: HCC Coder or Risk Adjustment Coder Duration: 03 Months (Possibility of Extension) Pay Rate: $27/hr on W2  Location: Remote Job Description: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI). Key Job Functions: Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Client IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set. Utilize HHS Risk...

Coder/Quality Review Analyst This position is responsible for timely and accurate quality review of both internal and vendor coding team members to assure compliance with coding guidelines and standards in addition to their foundation coding responsibilities. The position performs quality checks on coding and provides feedback to coders to assure the timely and accurate coding of medical charts for billing. This position also reviews and responds to coding-based denials for inpatient, hospital outpatient and professional fee claims and advises leadership on trends related to denials. In collaboration with HIM coding management, the coder/quality review analyst will assist with selection of coders and encounters to be reviewed, as well as education to be presented to the coder based on review outcomes. The coder/quality review analyst will also bring forward any issues related to documentation or systems as they are discovered during the review process. This position participates...

HIM Hospital Inpatient & Same Day Surgery Coding Analyst The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals...

Clinical Coder Position Work Shift: Day Shift Time Type: Full time Department: CC807200 PSO Professional Coding Summary: Monday to Friday, 8:00 a.m. to 5:00 p.m. Remote (Must reside in Arkansas, training will be onsite) The Clinical Coder is responsible for reviewing patient medical records and accurately assigning standardized codes using ICD and CPT/HCPCS classification systems. The primary goal is to ensure timely and accurate coding for billing, reimbursement, research, and statistical reporting purposes, while maintaining compliance with established coding guidelines and regulations. Required Education: No education requirements Required Work Experience: 3 years of relevant experience; HS Diploma or GED may substitute for 2 years of work experience Required Certifications: 1 certification from AAPC or AHIMA - American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) Description 1. Review patient medical records (e.g.,...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or payer...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

PRN Coder Analyst IV Marshall Health Network's Health Information Management department is seeking a PRN Coder Analyst IV. System Specific Duties and Responsibilities: Assign accurate diagnosis and procedure codes using ICD-10-CM/PCS, CPT, and/or HCPCS for reimbursement, compliance, and reporting purposes. Utilizes coding guidelines set up by government agencies dealing with the coding of health information. Demonstrates, promotes, and monitors for high standards of quality and productivity; focuses on quality results first. Maintains a standard of productivity that consistently meets or exceeds 98% of productivity. Maintains a standard or quality that consistently meets or exceeds 95% accuracy rate. Proficient to expert level knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code sets. Proficient to expert level knowledge of MS-DRG and APR-DRG groupers and Medicare's inpatient prospective payment system (IPPS) and outpatient prospective payment system (OPPS)....

Supervisor, Medical Staff Services & Credentialing All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Position Summary The Supervisor, Medical Staff Services & Credentialing, is responsible for the day-to-day operational supervision, oversight, and performance management of the Medical Staff Office credentialing team and administrative support functions. This role ensures that all medical staff credentialing, privileging, reappointment, and related Medical Staff processes are executed in full compliance with The Joint Commission (TJC), CMS, Medicaid, NCQA, Medical Staff Bylaws, and organizational policies. In addition, the Supervisor serves as a key operational partner to the Senior Director of Physician Services and the Delegation Analyst to ensure alignment, accountability, and consistency across credentialing and...

Coder Analyst Specialist, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives....

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Apply for Job Job ID 83608 Location Sacramento Full/Part Time Part Time Add to Favorite Jobs Email this Job Job Summary #CA-KN Under the general direction of the Supervisor, incumbent performs abstracting of medical services provided by UCDHS and affiliates. Incumbent identifies all billable services (IP Professional, Outpatient professional and facility, Hospital Service Departments, Freestanding, and Ancillary Services), CPT-4, ICD-10, and HCPCS codes for billing purposes to government agencies, insurance companies and patients. Incumbent is responsible for the accuracy of above procedure and diagnosis coding relative to corresponding documentation and standards. Incumbent will ensure compliance to all federal, state and carrier specific rules, regulations and requirements related to professional fee services are adhered to. Apply By Date: 1/19/2026 at 11:59 pm - Interviews and recruiting process may occur at any time Minimum Qualifications - For full...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217 Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical...

Ivyhill has an immediate need for a Regulatory Analyst Coder that will support their Publication Surveillance project. The position will mostly be remote, but may require travel to our Hyattsville, MD location. This is an excellent opportunity for a detail-oriented professional with strong analytical skills to join a dynamic team focused on regulatory compliance and data evaluation. (Note: This position does not involve IT or programming coding. It entails inputting, organizing, and classifying data to identify themes and relationships within regulatory content.) Key Responsibilities: Apply analytical methodologies and regulatory principles to support compliance initiatives. Evaluate industry data and advertising materials to identify trends and implement strategic response. Collect, code, and model data to create performance measurements aligned with project goals. Organize and classify regulatory data to identify key themes, issues, and patterns....

Ivyhill has an immediate need for a Regulatory Analyst Coder that will support their Publication Surveillance project. The position will mostly be remote, but may require travel to our Hyattsville, MD location. This is an excellent opportunity for a detail-oriented professional with strong analytical skills to join a dynamic team focused on regulatory compliance and data evaluation. (Note: This position does not involve IT or programming coding. It entails inputting, organizing, and classifying data to identify themes and relationships within regulatory content.) Key Responsibilities: Apply analytical methodologies and regulatory principles to support compliance initiatives. Evaluate industry data and advertising materials to identify trends and implement strategic response. Collect, code, and model data to create performance measurements aligned with project goals. Organize and classify regulatory data to identify key themes, issues, and patterns. Support...

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 rapidly changing healthcare...

Job Description Job Description Salary: Billing Analyst (Contract-to-Hire) Plano, TX (Hybrid) We are seeking a detail-oriented and proactive Billing Analyst to join our team on a contract-to-hire basis. This role supports key billing and revenue cycle functions, with a strong focus on analyzing payment trends, identifying payer issues, and driving denial resolution. Ideal candidates bring a quality assurance mindset, strong analytical skills, and hands-on DME billing experienceespecially with oxygen-related products. Key Responsibilities Hybrid schedule: On-site 3 days per week in Plano, TX Analyze billing, claims, and payment data to identify trends, irregularities, and denial patterns Investigate root causes of denied/underpaid claims, including policy discrepancies and documentation gaps Recommend and implement corrective actions to prevent future denials and improve collections Collaborate with billing, coding, and reimbursement teams to strengthen process accuracy...

Overview This position is responsible for timely and accurate quality review of both internal and vendor coding team members to assure compliance with coding guidelines and standards in addition to their foundation coding responsibilities. The position performs quality checks on coding and provides feedback to coders to assure the timely and accurate coding of medical charts for billing. This position also reviews and response to coding-based denials for inpatient, hospital outpatient and professional fee claims and advises leadership on trends related to denials. In collaboration with HIM coding management, the coder/quality review analyst will assist with selection of coders and encounters to be reviewed, as well as education to be presented to the coder based on review outcomes. The coder/quality review analyst will also bring forward any issues related to documentation or systems as they are discovered during the review process. This position participates in the onboarding...