9 compliance auditor jobs found in Durham, NC

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. Compliance Auditor 5119 - G1 Occupational Summary Conduct health-system wide compliance audits to ensure data integrity, compliance with federal and state regulations pertaining to but not limited to: federal healthcare program requirements, clinical trials billing, privacy, conflict of interest, and anti-kickback and physician relationships. Exercise independent decisions using analytical and problem solving skills. Provides critical analytical and support with respect to third party payer external audits (i.e. RAC, ADR/TPE, UPIC, etc.). Work Performed Interpretation of applicable federal and state law and regulations to plan audit parameters, determine department's compliance with such regulations and communicate to department...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Inpatient Medical Coding Auditor As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review ICD-10 inpatient patient records for accuracy and compliance Review physician documentation to verify diagnosis and procedures Communicate with physicians to obtain or clarify diagnosis and/or procedures via the query process Assign accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Companys clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up-to-date with industry standards...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Medical Coder With Anesthesia Coding Expertise We are seeking a skilled and detail-driven Medical Coder with anesthesia coding expertise to join our team. The ideal candidate will accurately assign CPT, ICD-10, and HCPCS codes (including modifiers) for surgical, procedural, and office-based reports in compliance with CMS coding guidelines. This role also provides billing and coding support across clinics as needed, ensuring accuracy, timeliness, and compliance in all aspects of coding and documentation. Key Responsibilities: Review and code office visits, surgical procedures, and anesthesia-related reports using accurate CPT, ICD-10, and HCPCS codes. Ensure all coding follows CMS, payer-specific, and compliance guidelines. Provide clinic-wide billing and coding support, assisting with reconciliation, claims review, and error resolution as needed. Audit and correct clinic fee tickets, procedure charges, and hospital reports for accuracy and completeness. Manage...

Medical Coder Opportunity French Consulting is seeking a Medical Coder to deliver expert healthcare administration support at the Federal Correctional Complex in Butner, North Carolina. You'll play a pivotal role in ensuring efficient healthcare administration. Your efforts will directly contribute to positive patient outcomes supporting efficient use of taxpayer's investment in community security. What You'll Do Assign Evaluation and Management (E&M) codes, International Classification of Diseases, Clinical Modification (ICD-CM) diagnoses, Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for the professional and institutional (facility) components of outpatient primary care encounters. Review encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding,...

Job Description Job Description We are looking for individuals who want to join our team in Butner, NC. Apply now! Job Opportunity : Medical Coder Location :  Federal Correctional Complex, Butner, North Carolina Start Date : Immediate Schedule : 30 hours/week Make a Difference Behind the Mission Are you passionate about providing detail oriented medical administration? Do you want your work to directly support the health and well-being of incarcerated inmates in North Carolina prisons? If so, this opportunity might be a perfect fit. French Consulting is seeking a Medical Coder to deliver expert healthcare administration support at the Federal Correctional Complex in Butner, North Carolina. You’ll play a pivotal role in ensuring efficient healthcare administration. Your efforts will directly contribute to positive patient outcomes supporting efficient use of taxpayer’s investment in community security. What You’ll Do Medical Coding   Assign Evaluation and...

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

Job Description Job Description SUMMARY:  Responsible for billing team leadership, subject matter expertise and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for Medical and Dental services rendered by First Choice Community Health Center (FCCHC) providers. Supervises billing specialists to ensure all tasks are completed timely and accurately. The Revenue Cycle Manager is expected to devote 50% of work time to learn leadership and subject matter expert responsibilities.  The Revenue Cycle Manager should proactively seek to further develop billing process competencies; and assist in implementation of process improvements.  ESSENTIAL DUTIES AND RESPONSIBILITIES Team Leadership Supervise and coordinate the workload of the billing staff to ensure all task are completed accurately and in a timely manner. Define and communicate current and new billing tasks and definitions of the billing team. Recommend and report billing...