1755 compliance coding auditor jobs found

Employment Type: Full time Shift: Day Shift Description: Trinity 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. Repots 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 providers for corrective educational guidance. Maintains complete knowledge and complies with all relevant insurance, CPT coding and diagnosis guidelines Provides training for IHA staff and providers on CPT, ICD10 and HCC coding standards and procedures. General...

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...

Position Summary The Associate Compliance Coding Auditor performs routine coding and documentation audits using established methodologies, regulatory guidance, audit tools, and standard operating procedures. This role develops proficiency in compliance auditing through structured onboarding, mentoring, calibration, and quality review. Essential Duties and Responsibilities • Conduct assigned routine coding and documentation audits using established audit methodologies, tools, templates, and standard operating procedures. • Review medical record documentation for appropriate CPT, ICD-10-CM, HCPCS, modifiers, and other applicable coding and documentation requirements. • Accurately document audit findings and supporting rationale in MDaudit or other designated systems. • Complete assigned audits through the established workflow, including finalization, communication, education handoff, and closure requirements. • Escalate complex, unclear, or potentially high-risk...

Senior Compliance Coding AuditorReporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices.ResponsibilitiesEssential Functions:Auditing...

Trinity Health IHA Medical Group is seeking a Compliance Coding Auditor-Educator to serve as the subject matter expert for CPT, ICD and HCC coding across IHA offices. You will lead audits, report results, and provide corrective educational guidance to staff and providers. The role requires a bachelor’s degree and coding credentials (CPC or RHIT), with at least two years of experience in coding, reimbursement analysis, and medical record auditing. #J-18808-Ljbffr

Sentara Health in Norfolk, VA is seeking a Compliance Coding Auditor to conduct multi-specialty coding audits and ensure ethical reimbursement. The role requires CCI, NCD, and HCC knowledge, plus 4+ years in coding across various settings. The position emphasizes education, audit follow-up, and collaboration with leadership. The role supports remote work options for qualified Virginia/North Carolina candidates, with base compensation described in the posted pay range. #J-18808-Ljbffr

City/State Norfolk, VA Work Shift First (Days) Overview 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...

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...

Reporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices. Essential Functions Auditing and Monitoring Conduct retrospective 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...

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

Appalachian Regional Healthcare (ARH) is seeking a Compliance Specialist – Coding and Billing to design and execute risk-based audits aligned with the annual plan. Collaborate with the Director of Coding and Billing Compliance and the Chief Compliance and Privacy Officer to strengthen ARH’s internal audits, controls, and governance in line with federal and state healthcare laws. You will develop audit plans, analyze data, generate reports, and present findings to management, while maintaining #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

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, Texas seeks a Senior Compliance Coding Auditor to conduct independent coding, billing, documentation, and regulatory audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, #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 Auditor Optum 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,...

PACT MSO LLC in Branford, CT seeks a Medical Auditor to coordinate medical billing, coding, and documentation audits across clinical settings to ensure compliance with regulations and billing accuracy. You will educate clinicians and staff on audit findings, partner with revenue cycle leadership to strengthen documentation integrity, and drive compliant reimbursement practices. This role requires CPC certification and 3–5 years of healthcare auditing experience. #J-18808-Ljbffr

Coding Compliance Auditor 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 Auditor, you will be responsible for...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience...

Coding Auditor Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Job Description Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements....

Health Information Management Miami, FL Full-Time Jackson Health System Full Time Summary The HIM Coding Compliance Auditor 1 analyzes abstracted/coded data for the purpose of ensuring accuracy and timeliness as it relates to DNFB management, quarterly AHCA data submissions and PFS communication. Responsibilities Reviews quality of coded and abstracted data assuring coding compliance within the Jackson Health System. Performs target and focused MS-DRG, APC, CPT, Case mix and Medical Necessity reviews. Identifies monitors and corrects rejected claims due to HIM coding. Works as a liaison with PFS and other internal departments to serve as a communicator/problem-solver for hindrances that prevent reimbursement. Based on new coding requirements, audit findings, RACs, MACs, etc. prioritizes and supports develops training/education protocols for UHS hospital coders in ICD-9-CM, CPT-4, APCs, Emergency Room Evaluation and Management Coding, Level II coding guidelines,...

The Valley Health System in Ridgewood, NJ is seeking a Coding Auditor to perform comprehensive audits of professional coding, ensuring accuracy, compliance, and consistency across services. This role partners with a Coding Educator to drive education and quality improvements and supports vendor oversight and SLA adherence. Candidates should have at least 5 years of coding experience with CPC certification; CPMA/CPC-H are preferred. #J-18808-Ljbffr

Coding Compliance Auditor As a key member of the Amazon One Medical Revenue Cycle team the Coding Compliance Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. Demonstrating increased autonomy and strategic thinking and problem-solving skills, this role will perform detailed reviews of medical coding practices to ensure accuracy, compliance with regulatory requirements and adherence to organizational policies and procedures. This role reports into the Coding Compliance Auditing Manager, Revenue Cycle. As someone who naturally enjoys finding ways to improve the status quo, you adeptly identify and create processes necessary to get work done. You comfortably interact with your team members as well as other teams and easily tailor your message and communication style to different audiences. You have a high accountability bar and know how to motivate others,...