1159 documentation coding auditor jobs found

About the role We run a fast-growing care management program billed under partner clinic TINs across a mixed payer population. We need an expert to tighten CoCM billing yield while keeping documentation audit-proof as we scale from ~24 clinics to 100+. The right candidate will be able to convert this into a full-time role with equity, and grow with the company. Looking to hire ASAP. What you’ll own Design and audit CoCM and CCM billing workflows , including appropriate patient stratification between programs. Define clear, defensible criteria for assigning patients to CoCM vs CCM (and transitions over time). Build “gold standard” documentation templates and checklists for 99492/99493/99494, 99490, 99439 , and related codes as applicable. Design simple, audit-proof time capture and attribution workflows across care team members. Create and run a QA sampling plan with feedback loops for care teams and clinic billers. Partner with...

General Summary:   U.S. Urology Partners, LLC (USUP) and its physician groups are committed to promoting conduct that is responsible, ethically sound, and compliance with applicable law.  USUP’s Compliance Department (CD) fosters a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws and regulations that govern the delivery and reimbursement of health care.  An integral function of USUP’s compliance program is auditing and monitoring compliance with billing, coding, and documentation requirements of its providers.    An CPC, CCS-P, or CPMA is required for this position.     Compliance Audit Services:   Compliance audit initiatives include physician, other providers, and facility documentation audits as well as preparation of guidance documents and tools to assist physicians and staff in appropriate billing, coding, and documentation.  The audit program looks at professional fee billing,...

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The  System Professional Coding Provider Review and Education Manager  is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...