1933 compliance coding auditor jobs found

Sentara Health Plans in Norfolk, VA, is seeking a Compliance Coding Auditor to perform internal coding audits, physician education, and AR query management. The role requires expertise in CCI, NCD, and HCC guidelines, and mastery of MPFS impact on RVU for NPP services. Remote work is favored for VA/NC candidates. Ideal candidates have CPC/CCS certification and 4+ years of multi-specialty coding experience, including acute care outpatient coding and professional fee coding. #J-18808-Ljbffr

Sentara Health Plans in Norfolk, VA, is seeking a Compliance Coding Auditor to perform internal coding audits, physician education, and AR query management. The role requires expertise in CCI, NCD, and HCC guidelines, and mastery of MPFS impact on RVU for NPP services. Remote work is favored for VA/NC candidates. Ideal candidates have CPC/CCS certification and 4+ years of multi-specialty coding experience, including acute care outpatient coding and professional fee coding. #J-18808-Ljbffr

A leading healthcare management firm is seeking a Compliance Coding Auditor to support its Compliance & Ethics Program. The role involves auditing and monitoring compliance in healthcare practices, ensuring accurate coding and billing processes. Candidates should have 5-10 years of relevant experience in healthcare along with necessary certifications. The position offers comprehensive benefits including a full employer-paid HMO, generous PTO, and tuition reimbursement. #J-18808-Ljbffr

Join to apply for the Compliance Coding Auditor , ATM role at Advanced Medical Management, Inc. Your actual pay will be based on your skills and experience. Talk with your recruiter to learn more. Base pay range: $75,000 to $80,000 per year. Role Overview As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients, families, and government agencies. The Program is led by AMM’s Chief Compliance & Ethics Officer, who reports to the CEO and the Board, and oversees the AMM Compliance Committee. This role requires sound, risk‑aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to...

Compliance Coding Auditor Performs 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 year. All queries arising from the audit process are...

Compliance Coding Auditor-EducatorTrinity Health IHA Medical Group is looking for a customer-focused Compliance Coding Auditor-Educator to join our team. In this role, you will serve 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.What You'll Do:Develops and leads audit projects for medical record integrity.Reports audit results utilizing a standard reporting process.Identifies new errors while performing audits, investigates and assesses root cause.Performs one-on-one Audit meetings and provides for corrective educational guidance.Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelinesProvides training for IHA staff and providers on CPT, ICD10 and HCC coding standards and procedures.General Requirements:EDUCATION: Bachelor's degree or...

## Compliance Coding AuditorApplyremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR-104491**City/State**Norfolk, VA**Work Shift**First (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...

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 year.All queries arising from the audit process are managed...

## Compliance Coding AuditorApplyremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR-104491**City/State**Norfolk, VA**Work Shift**First (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...

Weill Cornell Medicine - Qatar is seeking a billing compliance professional to monitor physician billing activity for accuracy and policy adherence. You will track audits, analyze coding patterns, educate staff on compliant coding, and help implement improved controls and reporting. Ideal candidates hold a Bachelor's degree, 2–3 years in medical records or physician billing, 1–2 years as a coder, and CPC certification. #J-18808-Ljbffr

Kaiser Permanente is seeking a Compliance Specialist focused on coding functions within all settings of care to ensure alignment with national coding policies and procedures. You will assist with audit readiness, develop compliant documentation, and support regional leadership with findings and corrective actions. You will partner with operational, clinical, and compliance teams to sustain regulatory adherence, drive quality improvements, and maintain the KP code of conduct across all lines of #J-18808-Ljbffr

Appalachian Regional Healthcare Inc. is seeking a Compliance Specialist – Coding and Billing to design and execute risk-based audits of billing and coding in line with ARH's annual audit plan. The Compliance Specialist will work with the Director of Coding and Billing Compliance and the Chief Compliance and Privacy Officer to add value to ARH by bringing a systematic, disciplined approach to the creation and execution of the Compliance Department’s internal audits and investigations and #J-18808-Ljbffr

Job TitleThis 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...

Job TitleHealthcare Compliance AuditorJob DescriptionThis 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.Essential FunctionsConduct prospective and retrospective chart reviews 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 recommendations to compliance and executive...

Location: Pasadena, California, United StatesCompany: Kaiser PermanentePosted: 2026-08-21Kaiser Permanente is seeking a Compliance Specialist focused on coding functions within all settings of care to ensure alignment with national coding policies and procedures. You will assist with audit readiness, develop compliant documentation, and support regional leadership with findings and corrective actions.You will partner with operational, clinical, and compliance teams to sustain regulatory adherence, drive quality improvements, and maintain the KP code of conduct across all lines of#J-18808-Ljbffr

Location: Austin, Texas, United StatesCompany: Central HealthPosted: 2026-09-01Central 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

Trinity Health IHA Medical Group is seeking a Compliance Coding Auditor-Educator to serve as a subject matter expert for CPT, ICD and HCC coding procedures. The role involves leading audits, reporting results, and educating providers and staff on compliant coding standards. The position requires a Bachelor's degree or equivalent, CPC or RHIT, and at least 2 years in coding, reimbursement analysis, or medical record auditing. #J-18808-Ljbffr

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

Thank you for considering a career at Ensemble! Ensemble 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! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Outpatient Coding Compliance AuditorOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws,...

OSF HealthCare is hiring a Coding Auditor to review coding and documentation for accuracy and compliance. You will validate ICD-10-CM/PCS and CPT/HCPCS coding, support DRG billing, and respond to external audits to defend OSF coded data. Requires 3 years of hospital coding experience, and certifications such as RHIA/RHIT/CCS/CMA/CPC (AHIMA-CCS within 12 months). Remote options available in Illinois and beyond. #J-18808-Ljbffr

Tegria Services Group - US, Inc. is seeking a Certified Professional Medical Coding Auditor to evaluate accuracy and quality of coded medical records, perform monthly and targeted audits, and ensure compliance with coding guidelines and payer requirements. You will provide feedback, education, and support coder development while promoting revenue integrity across the organization. The role collaborates with Coding Manager and Leads, supports process improvements, and leverages AI tools to #J-18808-Ljbffr

Coding Compliance Auditor 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 Auditor, you will be responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements. The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians. Education Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field required Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferred Experience Experience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT, HCPCS,...

DaMar Staffing seeks a Coding Compliance Specialist to support coding, audit, and compliance across clinical services. You will ensure accurate code assignment, adhere to FQHC billing and reimbursement regulations, and contribute to risk mitigation through provider education and ongoing audits. The role involves travel to InclusivCare locations for onsite audits, education, and operational support, with focus on HIPAA and payer policy compliance. #J-18808-Ljbffr