1200 facility compliance auditor jobs found

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,...

The GEO Group is seeking a Compliance Auditor to perform day-to-day quality control audits across operational areas and to support accreditation standards. This role acts as a liaison for interpretation of compliance policies while escalating complex issues to senior administrators. Responsibilities include daily reviews, periodic accreditation audits, and generating reports. Travel for audits and occasional weekend/overnight hours are required to ensure timely validation and compliance with #J-18808-Ljbffr

Solventum is seeking a Senior Medical Auditor to perform monthly and quarterly audits of professional fee and facility coding, ensuring accuracy and compliance. The role supports clients and vendors, delivers educational sessions, and maintains HIPAA privacy standards across remote work with up to 10% travel within the US. The ideal candidate has 4+ years in ICD coding/auditing, AHIMA or AAPC credentials, strong attention to detail, and proficiency with CPT/PCS/ICD-10. #J-18808-Ljbffr

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Job Locations US-KY-Shepherdsville Category (Portal Searching): Security Officer Level Workdays Available: Friday, Saturday Shifts Available: Overnight Business Unit: AUS Overview Allied Universal, North America's leading security and facility services company, offers rewarding careers that provide you a sense of purpose. While working in a dynamic, welcoming, and collaborative workplace, you will be part of a team that contributes to a culture that positively impacts the communities and customers we serve. Job Description As a Security Guard Part Time Screening Compliance Auditor in Shepherdsville, KY, you will serve and safeguard clients in a range of industries such as Tech/Media/Telecom, and more. Join a leading team where flexibility meets opportunity. As a Part-Time Security Officer, you can build a schedule that works for you and explore new roles using our Claim a Shift platform. Learn more: aus.com/earnmore. As a Screener supporting a dynamic technology, media, and...

Join Our Caring CommunityThe Senior Medical Coding Outpatient Auditor is responsible for coding-focused audit activities, including identifying billing anomalies, validating coding accuracy, and ensuring compliance with outpatient coding and reimbursement guidelines. You will report to the Manager, Payment Integrity.Key ResponsibilitiesResearch claims anomalies to identify outpatient audit opportunitiesApply CPT/HCPCS coding guidelines and payer-specific rulesAnalyze how codes impact reimbursement (APC grouping, edits, bundling)Conduct detailed record to bill reviewsValidate appropriate code assignment and modifier usageDocument findings and support defensible audit determinationsProvide recommendations for recovery or educationPartner with clinical and analytics teams on audit strategiesUse Your Skills to Make an ImpactRequired Qualifications:CPC, COC, CCS, ROCC, RHIA, or RHIT Certification5+ years post certification experience with Outpatient Specialty Surgeries and...

Senior Auditor Allegheny Health Network Job Description General Overview: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. Essential Responsibilities: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for hospital/physician...

Inpatient/Outpatient Facility Coding Auditor PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA's Revenue and Compliance Advisory Program. Responsibilities Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following: ICD-10-CM and PCS/CPT/HCPCS code assignment MS-DRG and other DRG validation APC validation and charge capture Clinical documentation improvement Regulatory compliance for third party payors Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standards...

Job Title Primary Auditor for Validation of Compliance with Healthcare Requirements Job Description Are you looking for a career you can feel good about? We hire only those that strive to do their best. By joining our family, you'll receive the honor and recognition that comes with working for the industry's global leader in evidenced based rehabilitation. GEO provides complementary, turnkey solutions for numerous government partners worldwide across a spectrum of diversified correctional and community reentry services. From the development of state-of-the-art facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration and supervision of individuals in the community, GEO offers fully diversified, cost-effective services that deliver enhanced quality and improved outcomes. We believe that work is more than a place you go to every day. It is about being inspired and motivated to achieve extraordinary things....

About Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.This position requires an initial 60-day training period at our corporate office in Scottsdale, Arizona.Upon successful completion of training, the position will transition to a fully remote role.Job Responsibilities :Audit Medical Records...

Acute Inpatient Coding AuditorWe are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing.This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role.Job Summary:Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Clinical Coding And Compliance AuditorThe Clinical Coding And Compliance Auditor role is responsible for the accurate assignment of ICD and CPT codes of diagnoses and procedures for outpatient medical records in multiple outpatient settings.Required Minimum Knowledge, Skills, and Abilities (KSAs)Education: Associate's Degree in a science field preferred. Completion of an accredited program through AHIMA or AAPC preferred.License/Certifications: RHIT, RHIA, CCS, CCA, CPC, CPC-H, or CIRCC credential preferred.Experience: Two years of multi-specialty, preferably surgical coding experience, with CPT/ICD-10-CM/HCPCS/modifier coding for physician professional charges and a minimum of two years' experience in an acute care facility as an ASU Clinical Coder required.Additional Skills/Requirements Required: Experience coding E/M's, Outpatient Hospital Clinics, OBV, ASU, Professional Surgical CPT's, ED's, cardiac cath/angiography, and simple visit coding required.Additional...

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...

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,...

Medical Coding AuditorUNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. This position requires extensive knowledge and experience with E/M coding. $4,000 Sign-on Bonus. Minimum $56,173 - Midpoint $70,217. Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE.Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and...

Revenue Cycle Coder Lead-Inpatient CodingInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Lead Inpatient Coder, you will be a cornerstone of our medical coding department, providing essential leadership and strategic direction for our inpatient coding team. You will be instrumental in driving coding accuracy, ensuring regulatory compliance, and optimizing revenue cycle performance for complex medical cases, making a direct impact on our healthcare data integrity and financial health.Every day you will provide expert technical guidance, conduct comprehensive quality...

Lead Senior EHS Compliance AuditorAt AECOM, we're delivering a better world. Whether improving your commute, keeping the lights on, providing access to clean water, or transforming skylines, our work helps people and communities thrive. We are the world's trusted infrastructure consulting firm, partnering with clients to solve the world's most complex challenges and build legacies for future generations.There has never been a better time to be at AECOM. With accelerating infrastructure investment worldwide, our services are in great demand. We invite you to bring your bold ideas and big dreams and become part of a global team of over 50,000 planners, designers, engineers, scientists, digital innovators, program and construction managers and other professionals delivering projects that create a positive and tangible impact around the world.We're one global team driven by our common purpose to deliver a better world. Join us.Job DescriptionAECOM is seeking a senior professional to...

Inpatient/Outpatient Facility Coding AuditorPYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA's Revenue and Compliance Advisory Program.ResponsibilitiesApply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following:ICD-10-CM and PCS/CPT/HCPCS code assignmentMS-DRG and other DRG validationAPC validation and charge captureClinical documentation improvementRegulatory compliance for third party payorsWork in collaboration with the PYA executive team and other service lines to offer complete business solutions to clientsManage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standardsQualificationsProfessional...

Job Description Job Description Overview Are you looking for a career you can feel good about? We hire only those that strive to do their best. By joining our family, you'll receive the honor and recognition that comes with working for the industry's global leader in evidenced based rehabilitation. Who We Are: GEO provides complementary, turnkey solutions for numerous government partners worldwide across a spectrum of diversified correctional and community reentry services. From the development of state-of-the-art facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration and supervision of individuals in the community, GEO offers fully diversified, cost-effective services that deliver enhanced quality and improved outcomes. Why Work for GEO: We believe that work is more than a place you go to every day. It is about being inspired and motivated to achieve extraordinary things. Employee benefits play an...

Certified Er Medical Coding AuditorThe Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.Key ResponsibilitiesAudit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codesValidate E/M level selection for emergency department visitsEnsure compliance with payer guidelines and regulatory standards (CMS, HIPAA)Identify under coding, over coding, and documentation deficienciesPrepare detailed audit reports with corrective recommendationsProvide education and feedback to coders and providersTrain and mentor offshore coding teams on ER coding guidelines and audit findingsConduct regular quality review sessions and calibration meetings with offshore staffDevelop and update training materials, review SOPs, and coding...

Senior Medical AuditorAt Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.The Impact You'll Make in this RoleAs a Senior Medical Auditor, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:Performing monthly, quarterly pro-fee...

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...