2886 compliance coding auditor jobs found

Job Description Job Description Overview The Sr Compliance Coding Auditor performs complex coding audits across a range of services, including those delivered in correctional settings and through third-party billing vendors. This role serves as a subject matter expert on coding and documentation guidelines, identifying risks and preparing detailed audit findings. The position works closely with leadership to develop corrective actions and deliver education to providers and coders. This role also supports regulatory audits and provides guidance and mentorship to compliance staff. Responsibilities Plan and conduct complex coding audits using risk-based sampling and established methodologies. Review provider documentation, coding, and modifier usage to ensure compliance with coding standards and payer rules. Analyze findings, prepare detailed audit reports, and present results to providers, coders, and leadership. Support corrective action planning, education efforts,...

Sentara is seeking a Compliance Coding Auditor to perform physician education, internal auditing, coder education, and manage AR queries within a compliant coding framework. The role requires expertise in CCI, NCD, HCC, and MPFS, with a focus on RVU impacts for NPP services and PBB locations. Ideal candidates will have CPC or CCS, 4+ years in multi-specialty and acute care outpatient coding, and prior experience with professional fee coding, contributing to Sentara's mission-driven compliance #J-18808-Ljbffr

You Matter Make a difference every day in the lives of the underserved Join a mission driven organization with a people first culture Excellent career growth opportunities Join us and find a career that supports Caring for overlooked, underserved, and vulnerable patients Diversity, equity, inclusion, and belonging Autonomy in a warm team environment Growth and training Perks and Benefits In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including: DailyPay, receive your money as you earn it! Tuition Assistance and dependent Scholarships Employee Assistance Program (EAP) including free counseling and health coaching Company paid life insurance Tax free Health Spending Accounts (HSA) Wellness program featuring fitness memberships and product discounts Preferred banking partnership and discounted rates for...

Wellpath in California seeks a Sr Compliance Coding Auditor to perform complex coding audits across correctional and healthcare settings. You will serve as a subject matter expert on coding and documentation, identify risks, and deliver detailed audit findings to leadership. The role emphasizes accuracy, integrity, and collaboration within a mission-driven team. Responsibilities include reviewing documentation, supporting corrective actions, educating providers and coders, and guiding external #J-18808-Ljbffr

CVS Health is seeking a Program Integrity Auditor to review medical and behavioral health records to ensure accurate coding and documentation. The role involves audits across Medicaid lines, identifying FWA, and coordinating regulator reporting with a focus on compliance and education for providers. Qualifications include 3–5 years in claims data review and medical records, CPT/HCPCS/ICD-10 proficiency, and an active CPC/CCS/CPMA license. 40-hour workweek and comprehensive benefits offered. #J-18808-Ljbffr

City/StateNorfolk, VAWork ShiftFirst (Days)Overview:Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one...

CaroMont Health in Gastonia, NC seeks a compliance auditor/coder to implement and maintain a system-wide program ensuring accurate coding and documentation in line with federal guidelines. The role leads provider meetings, prepares audit reports, and supports risk assessments and annual planning. Requires a health information management degree or 5–10 years of audit/coding experience, plus CPC/COC/CCS certifications and strong regulatory knowledge. #J-18808-Ljbffr

Compliance Auditor/Educator The Compliance Auditor/Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services. Provides professional expertise and education in CPT, ICD and HCC coding. The Compliance Auditor/Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations. This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution. Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance. Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies problems and...

OverviewThis position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff.This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis.ResponsibilitiesEssential Duties :Conduct prospective and retrospective chart reviews (i.e.baseline, routine periodic, monitoring, and focused) comparing medical and / or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer / title / grant coding requirements.Identify coding discrepancies and formulate suggestions for improvement.Communicate audit results / findings to providers and / or ancillary staff and share improvement ideas.Work with the Office of the CMO and provider leadership to identify and assist providers with coding.Report findings and recommendations to Compliance...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...

Central Health in Austin, TX is seeking a Healthcare Compliance Coding Auditor to conduct coding audits and communicate results to providers, staff and leadership. The role includes training, reviewing CPT/HCPCS and ICD-10 codes, and updating coding processes annually. Responsibilities include identifying coding discrepancies, guiding improvements, and ensuring compliance with Medicare/Medicaid and private payers. Collaboration across departments and ongoing education are required. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits and provide actionable feedback. The role requires strong ICD-10-CM/PCS and CPT coding knowledge, plus attention to detail in data abstraction and documentation review. Candidates should have 5 years of coding experience (1+ year as a coding auditor) and hold a relevant certification (CCS, CPC, RHIA, RHIT, CIC, etc.). This on-site position emphasizes accuracy and compliance within our health system. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits, provide feedback, and help ensure accurate coding and classification. You will work with ICD-10-CM/PCS, HCPCS, CPT and related references, supporting compliance and continuous improvement in documentation practices. Ideal candidates have 5 years of coding experience, with at least 1 year as a coding auditor, and hold RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC certifications. #J-18808-Ljbffr

Baylor Scott & White Health in Missouri is seeking a Coding Auditor I to perform coding quality reviews across ICD-10-CM/PCS, HCPCS, CPT and related references. You will collaborate with Clinical Documentation Specialists and coders to ensure accurate and compliant documentation and data abstraction. The role requires strong knowledge of coding rules, HIPAA compliance, and the ability to identify opportunities for improvement. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor 1 to perform coding quality audits and provide feedback to coders. The role uses ICD-10-CM/PCS, HCPCS, CPT and related references to ensure accurate coding and classification, including DRG/APC groupings. Minimum qualifications include 5 years of coding experience with at least 1 year as a coding auditor and one of several coding certifications. The organization emphasizes compliance, collaboration with Clinical Documentation Specialists #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor 1 in Santa Fe, NM to perform coding quality audits using ICD-10-CM/PCS, HCPCS, CPT and related references. The role collaborates with Clinical Documentation Specialists to improve documentation accuracy and compliance. Requirements include 5 years of coding experience with at least 1 year as a coding auditor and a valid coding certification such as CCS, CCS-P, CPC, COC, CIC, CIRCC, RHIA, or RHIT. #J-18808-Ljbffr

Baylor Scott & White Health in Columbia, SC seeks a Coding Auditor 1 to perform coding quality audits using ICD-10-CM/PCS, HCPCS, CPT and other references. You will provide feedback to coders and ensure accurate classification. The role requires five years of coding experience with one year as a coding auditor and certifications such as RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC. You will collaborate with Clinical Documentation Specialists to improve documentation quality and compliance. #J-18808-Ljbffr

Job Description Job Description Overview Opportunities for you! Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek Free Continuing Education and certification Tuition reimbursement, education programs and scholarships Vacation time starts building on Day 1, and builds with your seniority Free money toward retirement with a 403(b) and matching contributions Great food options with on-demand ordering Free parking and electric charging Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. Responsibilities The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance...

Walt Disney is seeking an experienced Auditor to review medical records, coding, and billing practices, ensuring compliance with industry standards. The role requires expertise in medical office procedures, coding systems, and terminology to conduct thorough audits. Responsibilities include audits of claims, reporting findings, and providing education to staff. Remote/hybrid work options may be available; prior HIM coding leadership interaction is valued. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits using ICD-10-CM/PCS, HCPCS, CPT and related references. The role analyzes documentation and ensures accurate code assignment and proper DRG groupings. Successful candidates will have 5 years of coding experience, one of several approved certifications (RHIA/RHIT/CCS/CCS-P, CPC, CIC, CIRCC, COC, CPC, etc.) and strong collaboration with clinical teams to improve documentation and compliance. #J-18808-Ljbffr

Job Summary : Assists with implementing and maintaining a system-wide effective compliance program through performance of compliance and coding quality audits. Under indirect supervision, assures appropriateness and accurate coding assignments in accordance with federal coding regulations and guidelines. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional and facility fee documentation, coding and billing, including CMS and OIG compliance standards. Leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Prepares written reports of findings. Also responsible for providing assistance with coding inquiries from providers, coders, billing staff, etc. Monitors relevant resources and publications related to high-risk compliance areas. Serves as an audit software system administrator as assigned....

Baylor Scott & White Health is seeking a Coding Auditor to perform coding quality audits, provide feedback, and ensure accurate code assignment using ICD-10-CM/PCS, HCPCS, and CPT. The role requires extensive knowledge of coding rules, HIPAA compliance, and collaboration with CDI specialists. You will abstract and validate data, support documentation improvement, and complete production coding as needed, contributing to high-quality healthcare coding outcomes. #J-18808-Ljbffr