234 compliance auditor jobs found in New York, NY

Molina Healthcare is seeking a compliance auditor to provide audit support for Social Adult Day Centers, ensuring adherence to state regulations. The role requires significant travel throughout NYC for on-site audits and investigations in order to support regulatory compliance. The ideal candidate will have at least 3 years of relevant experience in the healthcare field, a strong understanding of contract management, and familiarity with Medicaid and Medicare regulations. A competitive compensation and benefits package is offered. #J-18808-Ljbffr

Dormont Manufacturing Co is seeking a Compliance Auditor to enhance the quality of clinical and financial documentation. This role involves auditing clinical documentation, ensuring compliance with billing codes, and collaborating with personnel to recommend process improvements. The ideal candidate should have a Bachelor’s degree in Health Information Management, relevant certifications, and a minimum of three years of experience in coding and compliance audits. A comprehensive benefits package is offered. #J-18808-Ljbffr

School Compliance Auditor The School Compliance Unit (SCU) is responsible for monitoring and enforcing compliance with school immunization requirements among children and students enrolled in childcare centers and schools (grades kindergarten through 12) in New York City (NYC). The unit covers more than 1.2 million students enrolled in roughly 5,381 public and non-public schools and childcare centers throughout NYC. The mission of the Bureau of Immunization (BOI) is to prevent the occurrence and transmission of vaccine-preventable diseases (VPDs) through comprehensive immunization programs. BOI promotes immunization across the lifespan from infancy through adulthood, works to eliminate disparities in vaccination coverage through data evaluation and support of equitable vaccination services, and actively responds to VPD outbreaks to mitigate their spread and impact on communities. The School Compliance Unit (SCU) supports policy implementation by translating regulatory...

Position Type: Full-Time or Part-Time Work Arrangement: In-person Salary: $70,000–$80,000 annually LaSante Health Center is a community health center serving patients in Brooklyn with a strong commitment to accessible, high-quality care. Our Behavioral Health Department continues to grow, and we are seeking a detail-oriented Behavioral Health Compliance Auditor to support clinical documentation quality, compliance, and chart review processes. Position Overview The Behavioral Health Compliance Auditor will be responsible for reviewing behavioral health charts to ensure documentation is complete, clinically appropriate, and aligned with regulatory, billing, and internal compliance standards. This role will focus primarily on chart audits, documentation review, treatment plans, progress notes, intake documentation, safety planning, and other behavioral health compliance needs. This is an in-person role and may be structured as either full-time or part-time depending on the...

LaSante Health Center is looking for a Behavioral Health Compliance Auditor to oversee the quality of clinical documentation in their Behavioral Health Department. The role includes conducting audits of health charts and ensuring compliance with regulatory standards. The ideal candidate should have a Master’s degree in a related field and experience in behavioral health compliance. This position can be offered as full-time or part-time based on the applicant's credentials and preferences. #J-18808-Ljbffr

To support the Amazon One Medical Revenue Cycle team, the full-time Certified Coding Compliance Auditor will conduct detailed audits of medical coding practices, ensuring compliance with regulatory requirements and organizational policies while working remotely. Key responsibilities Conduct regular audits to verify the accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes Review documentation to ensure appropriate code assignment and adherence to medical necessity requirements Track and report coding errors and findings, maintaining detailed records of audit results Required qualifications Associate's degree in a related field 3+ years of coding/auditing experience in professional fee and/or risk adjustment settings Knowledge of industry standard code sets and guidelines (ICD-10-CM, CPT, HCPCS) CPC certification through AAPC and/or CCS certification through AHIMA required CPMA and CRC certification through AAPC required

Amazon is looking for a Coding Compliance Auditor to join its Revenue Cycle team. The role involves conducting audits to ensure the accuracy and compliance of medical coding practices. Candidates should have 3+ years of experience and appropriate certifications. The position offers a salary range between $56,700.00 and $99,300.00 annually, along with comprehensive benefits including health insurance, 401(k) matching, paid time off, and parental leave. #J-18808-Ljbffr

To support a growing compliance team, the full-time Washington Licensed Compliance Auditor will conduct audits to evaluate adherence to Federal and State laws, regulatory rules, and internal policies while working remotely. Key responsibilities Conduct audits across various revenue cycle departments, focusing on compliance with laws and regulations Analyze data from Clinical EMR and Epic Billing systems, reviewing charges, codes, and supporting documentation Present audit findings collaboratively to reduce risk and ensure compliance within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant experience in hospital billing auditing or coding 5 years of recent experience in hospital billing auditing or hospital coding

To support compliance initiatives, the full-time California Licensed Compliance Auditor will conduct audits evaluating adherence to federal and state regulations, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits on clinical and non-clinical services to ensure compliance with regulations and internal policies Analyze data from Clinical EMR and Epic Billing systems, identifying discrepancies and ensuring accuracy in billing practices Collaborate with various departments to present audit findings and contribute to risk reduction efforts Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant hospital billing auditing experience 5 years of recent experience in hospital billing auditing or coding

Seeking a detail-oriented Billing Compliance Auditor with law firm experience, this fully remote position will manage front-end pre-bill audits, conduct line-by-line invoice reviews, and resolve billing discrepancies while collaborating with attorneys and the billing department. Key responsibilities Conduct front-end pre-bill audits for insurance defense matters before invoices are submitted to carriers Perform line-by-line invoice review to verify accuracy, reasonableness, and compliance with carrier billing guidelines Prepare, submit, and track formal billing appeals, coordinating with the billing department to adjust invoices based on appeal outcomes Required qualifications Minimum 3-5 years of direct front-end bill review experience in an insurance defense law firm or equivalent experience with an e-billing platform provider Proven ability to audit billable hours for attorneys and other timekeepers prior to carrier submission Strong knowledge of UTBMS task codes, carrier...

Working remotely, the full-time salaried Compliance Auditor will conduct audits to evaluate compliance with federal and state regulations, focusing on revenue cycle departments and clinical documentation while collaborating with various teams to present findings aimed at reducing risk. Key responsibilities Conduct audits of clinical and non-clinical services to ensure compliance with relevant regulations and policies Analyze data from Clinical EMR and Epic Billing systems, reviewing charges, codes, and supporting documentation for accuracy Present audit findings collaboratively to stakeholders, aiming to mitigate risks within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of recent hospital billing auditing or coding experience 5 years of recent hospital billing auditing or coding experience

To support compliance efforts, the full-time Texas Licensed Compliance Auditor will conduct audits on clinical and non-clinical services, analyze data across EMR and billing systems, and collaborate with various teams to ensure adherence to federal and state regulations while working remotely. Key responsibilities Conduct audits to evaluate compliance with federal and state laws and organizational policies Analyze data from clinical EMR and Epic Billing systems, reviewing charges and supporting documentation Present audit findings collaboratively to reduce risk within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant hospital billing auditing experience 5 years of recent experience in hospital billing auditing or hospital coding

To ensure compliance with regulatory and organizational requirements, the full-time Certified Compliance Auditor will perform risk-based audits of clinical documentation, coding, and billing records, while working remotely and managing audit workloads independently. Key responsibilities Conduct risk-based audits of clinical documentation and billing records to validate compliance with regulations Evaluate accuracy in coding, billing, and documentation practices, and identify compliance risks Prepare audit reports summarizing findings and recommendations for compliance leadership and stakeholders Required qualifications Bachelor's Degree in Health Information Management, Healthcare Administration, or related field, or equivalent experience 3 years of progressive experience in coding or regulatory compliance auditing in a healthcare setting Strong knowledge of federal and state laws, third-party payer regulations, and documentation requirements Certified Professional Coder (CPC)...

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders. Key responsibilities: Perform coding compliance and quality audits in support of the Compliance Program and client expectations Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans Required qualifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC) 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS...

To support a growing pediatric practice, the remote Coding Compliance Auditor will ensure accurate and compliant coding by reviewing medical records, conducting audits, and collaborating with clinical and compliance teams in a high-growth environment. Key responsibilities Review medical records and clinical documentation to ensure compliance with coding standards and regulations Conduct routine and focused coding audits to identify discrepancies and compliance risks Communicate audit findings and provide education to providers and coding staff to enhance documentation practices Required qualifications 5+ years of experience in professional fee coding and auditing, with a focus on E/M and outpatient coding Knowledge of medical terminology and coding systems such as CPT, HCPC, ICD-10, and DRG Prior coding or auditing experience in a Medicaid environment Bachelor's degree in healthcare management or related field preferred CPC, CCS, and CPMA certifications required

To support compliance efforts, the full-time Oregon Licensed Compliance Auditor will conduct audits to evaluate adherence to Federal and State laws, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits across clinical and non-clinical services, including revenue cycle departments and billing offices Analyze data from Clinical EMR and Epic Billing systems to ensure accuracy and compliance Present audit findings collaboratively to reduce risk within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a similar field, or 5 years of relevant auditing experience 5 years of recent experience in Hospital billing auditing or Hospital coding

To support compliance efforts, the full-time New Mexico Licensed Compliance Auditor will conduct audits on clinical and non-clinical services, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits to evaluate compliance with federal and state regulations, as well as internal policies Analyze data across Clinical EMR and Epic Billing systems, reviewing line-item charges and supporting documentation Present audit findings collaboratively to reduce compliance risks within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a similar field, or 5 years of relevant hospital billing auditing experience 5 years of recent hospital billing auditing or hospital coding experience

To support the Yale Medicine Administration, the full-time remote Compliance Auditor will coordinate and conduct medical billing audits across 18 clinical departments, ensuring compliance with coding and documentation standards while providing training and feedback to staff. Key responsibilities Complete audits of departmental compliance chart reviews and participate in third-party audits Assess provider documentation for ICD-10 and CPT-4 coding accuracy and compliance with regulations Conduct training sessions for physicians and departmental personnel on medical billing compliance Required qualifications CPC certification required, with the expectation to obtain it within 6 months to 1 year if not currently held Bachelor's degree in Health Care Management, Finance, Business, Nursing, or a related field Five years of experience in a multi-specialty group practice, academic plan, or hospital setting Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices Ability...

To support a growing compliance team, the full-time remote Montana Licensed Compliance Auditor will conduct audits to evaluate adherence to federal and state regulations, focusing on revenue cycle processes and collaborating with various departments to ensure accuracy and compliance. Key responsibilities Conduct audits of clinical and non-clinical services to assess compliance with regulations and internal policies Analyze data from clinical EMR and Epic Billing systems, reviewing charges, codes, and supporting documentation Present audit findings collaboratively to reduce risk and ensure compliance across the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant hospital billing auditing experience 5 years of recent experience in hospital billing auditing or coding

Providing support for compliance auditing activities, the full-time remote Compliance Auditor will evaluate adherence to regulatory requirements and internal policies while identifying compliance gaps and recommending improvements to mitigate risks related to fraudulent practices. Key responsibilities Perform ongoing compliance audits using state evaluation tools related to audit and monitoring activities Identify audit scope and criteria, review evidence, document findings, and recommend improvements Advise departments on compliance risks concerning federal and state regulations and assist in annual risk assessment and audit planning Required qualifications At least 2 years of experience in audit and/or compliance or equivalent education and experience Knowledge of relevant regulatory frameworks and compliance standards Understanding of internal control concepts and risk assessment methodologies Proficiency in Microsoft Office suite and applicable software programs Experience...

COMPLIANCE AUDITOR page is loaded## COMPLIANCE AUDITORremote type: On-sitelocations: NY Brooklyn / Prospect Place - 3rd Floortime type: Full timeposted on: Posted 2 Days Agojob requisition id: R2026-6185**JOB PURPOSE:**The Compliance Auditor will foster an environment that enhances and promotes compliance and adherence to all relevant federal, state, and local laws, rules and regulations applicable PACE, Part D, LHCSA and Article 28 requirements, etc., through audits. The Compliance Auditor is responsible for performing internal and external auditing functions for the Compliance Department of C2Q Health Solutions. **JOB RESPONSIBILITIES:**The Compliance Auditor applies advanced regulatory knowledge and analytical judgment to proactively conduct effective risk assessments and assist in preparing annual audit plan. Key responsibilities include:* Assist in conducing enterprise‐wide risk assessments and actively contribute to the development and execution of the annual compliance audit...

CenterLight Health System is seeking a Compliance Auditor in New York, NY. The role involves ensuring adherence to all relevant regulations through audits, conducting risk assessments, and developing audit plans. Candidates should have a Bachelor's degree and a minimum of three years' experience in healthcare audits. The position provides a salary range of $90,000 to $100,000 annually and requires strong analytical skills and an understanding of Medicare and Medicaid programs. #J-18808-Ljbffr

A leading healthcare organization in New York seeks an experienced Compliance Auditor to enhance revenue protection and compliance through government audits and medical record reviews. Responsibilities include conducting audits, developing education sessions for 500+ staff, and ensuring adherence to coding regulations. Applicants should have a Bachelor's Degree and substantial experience in billing and coding, along with strong analytical and communication skills. This is a full-time position with a focus on continuous compliance improvement. #J-18808-Ljbffr

Compliance Auditor Under general supervision, using a unique combination of clinical expertise and billing knowledge, the Compliance Auditor monitors and improves the quality of clinical and financial documentation related to the provision of patient services. The Compliance Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Compliance Auditor will utilize our technology to codify and quantify findings to assist with reporting, monitoring and educating where appropriate. Responsibilities Perform audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental and...