11 compliance auditor jobs found in Oklahoma City, OK

Position Title: Compliance Auditor - Dean McGee Eye Institute - Oklahoma Health Center Department: General Overhead Job Description: General Description: Under general direction of the Billing Compliance Director, this position is responsible for the identification, review, investigation and resolution of billing and coding compliance issues and patient complaints. This position is also responsible for chart auditing, report composition and reporting that clearly outline key performance indicators and provide educational feedback to those providers/service areas who are not in compliance with regulated billing and coding practices. The role of this position is to provide billing/coding compliance guidance/assistance to providers before, during or after account reviews are conducted or billing/coding compliance issues are identified in accordance with CMS billing guidelines. Essential Responsibilities: Responsibilities listed in this section are core to...

Overview Join Our Team at Oklahoma Heart Hospital (OHH) ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation. Why You'll Love Working Here: Comprehensive Benefits: Medical, Dental, and Vision coverage 401(k) plan with employer match Long-term and short-term disability Employee Assistance Programs (EAP) Paid Time Off (PTO) Extended Medical Benefits (EMB) Opportunities for continuing education and professional growth Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day! We can't wait for you...

Compliance Auditor Req number: R6613 Employment type: Full time Worksite flexibility: Remote Who we are CAI is a global technology services firm with over 8,500 associates worldwide and a yearly revenue of $1 billion+. We have over 40 years of excellence in uniting talent and technology to power the possible for our clients, colleagues, and communities. As a privately held company, we have the freedom and focus to do what is right-whatever it takes. Our tailor-made solutions create lasting results across the public and commercial sectors, and we are trailblazers in bringing neurodiversity to the enterprise. Job Summary As the Compliance Auditor, you will focus on trade compliance operations, ensuring timely and lawful movement of export-controlled goods and technology. Job Description We are looking for an experienced Compliance Auditor to focuses on trade compliance operations, ensuring timely and lawful movement of export-controlled goods and...

JOB DESCRIPTION Job Summary Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the Business understands and complies with applicable laws and regulations pertaining to the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. KNOWLEDGE/SKILLS/ABILITIES Performs on-going compliance audits utilizing as necessary, state evaluation tools relating to audit/monitoring activities. Identifies and defines audit scope and criteria, reviews and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified. Provides comprehensive advice to assigned department regarding compliance risks with respect to Federal and State regulations and contract provisions....

Overview ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients’ journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we’re shaping the future of heart care in Oklahoma by serving the state and leading the nation. Why You'll Love Working Here: Comprehensive Benefits: Medical, Dental, and Vision coverage 401(k) plan with employer match Long-term and short-term disability Employee Assistance Programs (EAP) Paid Time Off (PTO) Extended Medical Benefits (EMB) Opportunities for continuing education and professional growth Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day! We can’t wait for you to join our heart-centered team! Location: 7800 NW 85th Terrace, Oklahoma...

CRC Auditor The CRC Auditor conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and/or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and...

Inpatient/DRG Validation Coding Auditor Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support...

Coding Specialist Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. Minimum Qualifications: 1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. 2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS (Certified Coding...

Purpose of Position Performs ICD and CPT coding of inpatient and outpatient medical records. Responsibilities Analyzes, sequences and validates assigned codes based on medical record documentation using the automated encoder, book and coding compliance resources. Demonstrates complete understanding of coding rules, anatomy, physiology, and medical terminology to appropriately code patient information. Reviews all medical record documentation to determine and assign diagnoses, procedures, level codes and modifiers, to ensure appropriate coding for case mix. Selects the appropriate reimbursement grouper based on financial class for the particular account. Ensures that coding compliance, regulatory and reimbursement requirements are met through the process of assigning reimbursement classifications. Abstracts and enters diagnosis, procedures and level codes with demographic, clinical and related patient information into the Medical Record Abstracting and/or Billing/Accounts...

Health Information Coder (Remote Candidates Considered) – Cape Cod Healthcare Responsibilities Analyzes, sequences and validates assigned codes based on medical record documentation using the automated encoder, coding references and compliance resources. Demonstrates complete understanding of coding rules, anatomy, physiology, and medical terminology to appropriately code patient information. Reviews medical record documentation to determine and assign diagnoses, procedures, level codes and modifiers to ensure appropriate coding for case mix. Selects the appropriate reimbursement grouper based on financial class for the account. Ensures coding compliance, regulatory and reimbursement requirements are met through the process of assigning reimbursement classifications. Abstracts and enters diagnosis, procedures and level codes with demographic, clinical and related patient information into the Medical Record Abstracting and/or Billing/Accounts Receivable systems. Assesses...

Director Human Resources - Certified Human Resources Professional The Medical Coding Specialist plays a vital role in the healthcare revenue cycle by ensuring that all patient diagnoses, procedures, and services are accurately translated into standardized medical codes. This position requires a deep understanding of remittance and Form 835 validation, ICD-10, CPT, and HCPCS coding systems, as well as familiarity with medical terminology, payer guidelines, and healthcare regulations. The ideal candidate will possess strong analytical skills, excellent attention to detail, and the ability to interpret complex medical records. The Coding Specialist works closely with physicians, clinical staff, and billing teams to ensure accurate documentation, proper reimbursement, and full compliance with regulatory and payer requirements. Essential Duties and Responsibilities Assign Accurate Codes: Translate diagnoses, procedures, and treatments from medical documentation into standardized...