859 facility compliance auditor jobs found

The Position We seek to fill a Compliance Auditor role in the Cherry Hill, NJ area. The candidate will be responsible for supporting the corporate compliance program. The position includes a generous salary of up to $67K and benefits. (This is not a remote position). Compliance Auditor responsibilities include: Conducting audits of inpatient and outpatient hospital regulatory requirements, including billing, coding, and documentation, and related processes to determine the organizational integrity of billing facility and technical hospital fees, including detection and correction of documentation, coding, and billing errors. Preparatory work for reviews/audits including developing a scope of work. Reviewing available documentation. Assisting in the development of policies and procedures that establish standards for compliance, as well as preparation of other guidance documents and tools to assist providers and staff in appropriate billing, coding, and documentation....

About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick, birthday, and vacation time as well as a 410k matching plan. Additional employee paid coverage options available. Job Purpose The Medical Claims Coding Auditor supports the Managed Service Organization (MSO) by performing detailed medical claims reviews to ensure accuracy, compliance, and appropriate reimbursement across Medicare,...

Medical Coding Auditor UNM 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. $2,000 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...

Physician Coding Auditor Ensemble Health Partners 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! The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW....

Description QC Compliance Auditor KanPak is your ultimate resource for beverages and desserts. From juices to coffee drinks to delicious blended ice cream treats, we'll help you create the perfect product. Innovation, state-of-the-art manufacturing facilities, superior customer service and the highest quality ingredients are all part of the mix. We are seeking an energetic, skilled QC Compliance Auditor for expansion openings in our facility in Penn Yan, NY. This opportunity will require flexibility to work weekends and overtime. Main Functions: Is responsible for the final review of all plant documentation and practices that will ensure all products meet Regulatory, Customer, and Company requirements. At KanPak, a golden state foods company, we believe that investing in our associates strengthens our culture and fuels our growth. We care about your well-being, and will support you with the following: Paid time off subject to eligibility, including paid leave,...

Summary The Medical Records Technician (Coder) Auditor is located in the Health Information Management (HIM) section of Medical Administration Service at the VA Maryland Health Care System. A Medical Records Technician must possess expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), the Healthcare Common Procedure Coding System (HCPCS) and be skilled in classifying medical data from patient health records. Responsibilities Total Rewards of a Allied Health Professional Duties: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural...

Summary This position is in the Health Information Management (HIM) section at the Durham VA Health Care System. The Medical Record Technician (Coder) Auditor is responsible for abstracting medical record data and assigning codes using current clinical classification systems appropriate for the type of care provided. Responsibilities The duties of the Auditor will include, but are not limited to: Serves as expert of current coding conventions and regulations related to professional and facility coding. Performs audits of encounters to identify areas of non-compliance in coding. Provides recommendations on appropriate coding and is responsible for maintaining current knowledge of the various regulatory guidelines and requirements. Works with staff to ensure that regulations are met or areas of weakness are identified and reported to appropriate supervisor for corrective actions. Performs prospective coding audits and utilizes results to identify processing inadequacies and...

Medical Coding Auditor UNM 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. $2,000 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...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Benefits Information Full-time employees will enjoy a competitive benefits package with options for you and your family including: • Paid Time Off • Paid Holidays • 401(k) Matching • Health Insurance • Vision Insurance • Life Insurance • Health Savings Account • Tuition Reimbursement • Employee Discount • Reduced Tuition Rates • Disability Insurance • Employee Assistance Program • 401(k) • Pet Insurance • Dental Insurance • Paid Training • Flexible Spending Account The compensation and benefits information is accurate as of the date of this posting. The Company reserves the right to modify this information at any time, with or without notice, subject to applicable law. Equal Opportunity Employer 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...

Work where every moment matters. Every day, more than 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. The Revenue Compliance Auditor may be asked to assist in other compliance audits from time to time at the direction of his/her manage OCI leadership. Responsibilities include but, are not limited to the following: •...

Work where every moment matters. Every day, more than 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of Compliance and Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal, state and private payor regulations, guidelines and requirements. Documentation and coding audits may include professional, facility (inpatient and outpatient), home health and skilled nursing facilities. The Revenue Compliance Auditor may be asked to assist in other compliance audits from time to time at the direction of his/her manage OCI leadership.Responsibilities include but, are not limited to the following: · Conducts...

Inpatient Coding Auditor (PRN) Join Our Award-Winning Team and Work with the Best! We are thrilled to share that UASI has been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023, and 2024! With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we've built and the long-term success of our dedicated team. We are currently seeking an experienced facility inpatient Coding Auditor to join our team on a PRN basis. The Coding Auditor will perform inpatient coding audits and review services to client sites remotely from a home office. Additional responsibilities include: Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans Perform necessary research to provide to the client to support findings. Examples of this research include...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Opportunity 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. 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 important role in making The GEO Group a great...

Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 10,000 who are shaping the future we envision. Moffitt has been recognized as a Best and Brightest Company to Work for in the Nation, a Digital Health Most Wired Organization and continually named one of the Tampa Bay Time's Top Workplaces. A National Cancer Institute (NCI)-designated Comprehensive Cancer Center since 2001. Summary Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and...

Position Highlights: Compliance Auditors conduct Compliance Department audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including detection and correction of documentation, coding, and billing errors. The Compliance Auditor evaluates the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional or hospital documentation, coding and billing, and federal and state regulations and guidelines. The Compliance Auditor communicates audit results to physicians, physician leadership, senior management, management, and staff and provides physician and coder education. The Compliance Auditor will act as a liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs and will serve as an institutional subject matter...

A leading cancer treatment facility in Florida seeks a Compliance Auditor. This role involves conducting detailed audits of billing and compliance for professional and hospital services, along with training and education for providers. The ideal candidate should have a bachelor's degree and relevant experience in coding and auditing, with a strong understanding of regulatory guidelines. AAPC or AHIMA coding certification is required. Join us in ensuring compliance and delivering high-quality patient care. #J-18808-Ljbffr

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Job Summary The CRC Auditor conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims are coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and/or a formal appeal letter. The Auditor escalates trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor performs analysis on clinical documentation, evidence?based criteria application outcome, physician documentation, physician advisor input, and completes review of the medical record related to clinical denials. The Auditor ensures appropriate action is taken within appeal time frames, communicates identified denial trends and...

Job Posting Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards of...

Medical Coding Auditor UNM 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 position requires extensive knowledge and experience with E/M coding. $2,000 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 clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...