102 financial compliance auditor jobs found

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan, serving more than 2 million members to ensure they receive the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary: The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial Compliance Unit, including auditing claims processed by medical groups and health plans contracted with L.A. Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in a timely and...

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with L.A. Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in a...

Financial Compliance Auditor III Claims Job Category: Accounting/Finance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11887 Salary Range: $88,854.00(Min.) - $115,509.00(Mid.) - $142,166.00(Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents. The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with L.A. Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant 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 Integrity team in a quality assurance and project management role . RESPONSIBILITIES: Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required. The Consultant will assist PYA clients with provider...

Job Description Job Description Phys Financial LLC is a leading Medical Coding and Billing organization located in Lexington, KY, dedicated to providing exceptional services to our clients. We are seeking highly skilled and detail-oriented Orthopedic/Podiatry Coder to join our team. The successful candidate will play a crucial role in accurately assigning diagnoses and procedures for inpatient stays and outpatient encounters. As a key member of our team, you will ensure compliance with coding and billing guidelines while maintaining high-quality standards. Core Duties and Responsibilities: Review and interpret medical record documentation to identify relevant diagnoses and procedures, and assign appropriate ICD-10, CPT, HCPCS codes and modifiers. Ensure timely and accurate coding, charging, and abstraction of accounts for assigned specialty areas. Stay updated on coding guidelines through participation seminars, and continuous study. Maintain current certification and...

Job Description BAE Systems, Inc. is seeking an IT Compliance Auditor Sr Principal, focused on CMMC and internal audit efforts, to join our Audit Engagement team within the Governance and Compliance team, under the Enterprise Shared Services (ESS) IT Delivery Organization. The Audit Engagement Team delivers a centralized hub for comprehensive guidance to ensure consistent and efficient audit engagement and audit compliance operations across the enterprise. This role will merge the existing internal audit responsibilities, with specialized CMMC audit requirements, resulting in a new comprehensive integrated audit role. It involves overseeing and leading both internal audits and CMMC audit readiness efforts to ensure compliance, improve processes, and mitigate risks in line with organizational and regulatory standards. The primary purpose of this role is to develop a comprehensive, company-wide Cybersecurity Maturity Model Certification (CMMC) compliance program, ultimately...

Job Description Job Description Interview Type : Webcam only Work Arrangement : Onsite Engagement Type : Contract NOTE: Applications with resumes in PDF Format will be automatically rejected. Only Word format resumes will be considered. Short Description: The Community Based Contract Compliance Auditor will be part of a regional team that provides on-site monitoring and reviews of DCS community based contracted provider businesses. Complete Description: on-site monitoring and reviews of DCS community based contracted provider businesses. The auditor will conduct reviews throughout DCS regions 9, 10, and 11 which covers the central part of the state. Community Based reviews will evaluate DCS services and billing to assure there are no errors and billing has been performed appropriately. The auditor will educate, recommend and create plans of corrections when any errors are found. The auditor will conduct audits throughout the same regions as listed above. Community...

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant 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 Integrity team in a quality assurance and project management role . RESPONSIBILITIES: Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required. The Consultant will assist PYA clients with provider...

Job Description Job Description ** Please Note: This position is currently open and contiguous. We are considering candidates on an ongoing basis. We will notify candidates as our needs change.** Company Overview For more than 40 years, Williams Adley has provided expert accounting, auditing, and consulting services to a growing number of federal, state, and local government agencies. Our dedication to operating with the highest levels of honesty, integrity, and transparency means we frequently go beyond the typical “vendor/client” relationship, becoming trusted advisors to our clients. Williams Adley provides its employees with a unique experience for growth, career direction, and mentorship. As a member of our team, you will have a dynamic experience and work with great people. We offer a merit-based opportunity for all individuals that rewards aptitude, hard work, and determination. Join our team and thrive in an environment where your contributions are valued and...

Job Description Job Description ENT and Allergy Associates, LLP New York & New Jersey's premier ENT and Allergy medical practice, is seeking a self-motivated, people-friendly full time Regulatory Affairs Associate at our Corporate office location. SUMMARY: The Regulatory Affairs Associate (Compliance Medical Auditor) supports the functions of the Compliance Program for ENT and Allergy Associates, LLP, (ENTA) to be compliant with Federal and State guidelines in the prevention of fraud, waste, and abuse. The Compliance Medical Auditor will participate and provide duties such as, but not limited to conducting auditing and monitoring; providing training and education; assessing compliance with policies, procedures, and regulations; and identifying and recommending strategies for process improvements. The Compliance Medical Auditor performs auditing and monitoring of clinical documentation, analyzing medical records, and assessing the accuracy of ICD-10-CM diagnosis code...

Phys Financial LLC is a leading Medical Coding and Billing organization located in Lexington, KY, dedicated to providing exceptional services to our clients. We are seeking highly skilled and detail-oriented Orthopedic/Podiatry Coder to join our team. The successful candidate will play a crucial role in accurately assigning diagnoses and procedures for inpatient stays and outpatient encounters. As a key member of our team, you will ensure compliance with coding and billing guidelines while maintaining high-quality standards. Core Duties and Responsibilities: Review and interpret medical record documentation to identify relevant diagnoses and procedures, and assign appropriate ICD-10, CPT, HCPCS codes and modifiers. Ensure timely and accurate coding, charging, and abstraction of accounts for assigned specialty areas. Stay updated on coding guidelines through participation seminars, and continuous study. Maintain current certification and CEU's. Review and apply payer specific...

Job Description Job Description Exciting Opportunity with Banyan Treatment Centers! We are seeking a Billing and Coding Auditor to play a pivotal role in ensuring the accuracy and compliance of billed claims related to substance abuse and mental health services. This role will be key in reviewing claims, identifying inaccuracies, and communicating discrepancies to the billing team, as well as assisting in training staff on billing practices and compliance standards. About Banyan Treatment Centers: Banyan Treatment Centers is a nationally recognized leader in addiction and mental health care, offering a comprehensive continuum of services with the esteemed Joint Commission Accreditation (Gold Seal of Approval). Since our founding, we have grown into a trusted provider with 18 locations and Telehealth services nationwide. In 2023, TPG’s global impact investment through The Rise Fund enabled us to further expand our services. This partnership underscores our...

Introduction The Maryland Lottery and Gaming Control Agency (MLGCA) serves as one of the largest revenue sources for the State of Maryland, supporting important state programs and services including education, public health and safety, human resources and the environment. In addition to generating revenue from the sale of lottery products, the MLGCA is also responsible for the oversight of the state's casino gaming program, providing direction and guidance to its casino partners on financial, security, regulatory and licensing procedures for the facilities. The Agency also regulates Sports Wagering, Daily Fantasy Sports and Electronic Bingo, as well as Instant Ticket Lottery Machines, which are located at almost 90 Veteran's posts. Gaming in Maryland is a dynamic and growing business that operates around the clock, 365 days of the year. GRADE 19 LOCATION OF POSITION Maryland Lottery and Gaming Control Agency 1800 Washington Boulevard Baltimore, MD 21230...

Job Description Job Description Compliance Auditor Corporate Compliance Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the...

Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People's Lives Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. To better serve our customers, we are fostering a culture that emphasizes employee growth, collaborative innovation, and inspired leadership. We are dedicated to creating an environment where employees can excel and where top talent is attracted, retained, and thrives. As a testament to these efforts, Premera has been recognized on the 2025 America's Dream Employers list. In 2024, Newsweek honored Premera as one of America's Greatest Workplaces, America's Greatest Workplaces for Diversity, and America's Greatest Workplaces for Mental Wellbeing. Additionally in 2024, Forbes ranked Premera among America's Best Midsize Employers for the fourth time. Learn how...

Description The Revenue Integrity team within UI Health Care's Finance and Accounting Services has a new opportunity for a skilled Quality Assurance Coding Auditor to join the team. Under the direction of the Coding Quality Assurance & Education Manager, the Quality Assurance Coding Auditor conducts professional, facility, clinic, external vendor, coder, system, and denial coding audits. The role is responsible for creating, reviewing, and updating department processes, guidelines, and standards in adherence to regulatory changes and organizational compliance laws and regulations. This position will also identify, create, and provide individual or group education for clinical staff, providers, and coders. The Quality Assurance Coordinator liaises with Clinical Departments, Patient Financial Services, Revenue Integrity, clinical staff, and provider relations. Hybrid within Iowa: This position is eligible for a combination of on-campus and remote work. Remote work must...

Are you an experienced Medical Coder seeking a career growth? Are you a Certified Auditor interested in a new work opportunity? If so, then we want to connect with you! MAHEC is now hiring an Auditor / Provider Educator. This integral role supports MAHEC's mission of educating the next generation of healthcare professionals by completing internal quality assessment reviews on Care Provider coding and effectively builds relationships with MAHEC Care Providers to educate and foster complete, accurate, timely, and consistent coding. The Auditor/Provider Educator is responsible for documentation to ensure compliance with national coding guidelines and MAHEC policies. We welcome experienced Medical Coders interested in becoming a Certified Professional Medical Auditor, and MAHEC offers an employer-sponsored pathway to CPMA certification if hired for the position! This is a hybrid work opportunity, with roughly 50-60% onsite work to support in-person collaboration and...

PYA is seeking a Professional Coding Auditor/Consultant 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 Integrity team in a quality assurance and project management role. RESPONSIBILITIES: Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required. The Consultant will assist PYA clients with provider documentation improvement, reviews for billing and other regulatory compliance with third...

Job Description Job Description Company Description IntegriChain helps pharmaceutical manufacturers bring their science to market, ensuring patients have affordable, timely, and sustainable access to therapy. We are doing this by building pharmaceuticals' data-driven commercialization platform, from strategy to operational execution.  IntegriChain is uniquely focused on connecting the commercial, financial, and operational dimensions of drug access and profitability. We’ve brought together technology, data, consulting, and outsourcing capabilities that span contracting and pricing, channel management, patient support, and gross-to-net finance.  We are headquartered in Philadelphia, PA (USA), with offices in Ambler, PA (USA), Pune, India, and Medellín, Colombia. For more information, visit www.integrichain.com or follow us on Twitter @IntegriChain and LinkedIn. Job Description Your mission at IntegriChain: The mission of this role is to provide exceptional support in...

The rewards at Healogics are immense, starting with the important work we do to change patients' lives. We also understand that meaningful work is hard work, and we are committed to supporting and compensating our employees for the tremendous service they provide. Think you are a great fit? Learn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging society, obesity and diabetes on the rise, and an uptick in surgical procedures, the number of patients with non-healing wounds that would benefit from expert care is dramatically increasing. As a result, the company is working to provide our differentiated, quality outcomes to as many patients that would benefit through our out-patient clinic partnerships. The Compliance Coding Auditor is responsible for helping with the Compliance Department's Auditing activities, including...

Coding Auditor Educator at Highmark Health in Boise, Idaho, United States Job Description Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing,...

Overview: Compliance Medical Auditor - Stony Brook CPMP Compliance Location: St. James, NY ( At the managers discretion, this role may be eligible for remote work; this position is only available to New York State Residents). Schedule: Full Time Days/Hours: 8am - 4:30pm Salary Range: $69,715 - $76,854 (pay will be determined based on experience, preferred qualifications, and education) Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee. Responsibilities: SUMMARY: The SB Clinical Practice Management Plan, Inc. (CPMP) Compliance Medical Auditor...

Job Description Job Description Salary: BMC is a diverse company that provides accounting, auditing, and management consulting services to public and private clients nationwide. Our employee-friendly company environment emphasizes quality of life, initiative, creativity, strong work ethics, and loyalty. We seek a qualified, motivated, and progressive individual to join our team as a Lead Compliance Auditor (Project Management). Position Summary This role will ensure that the team performs on time, meets expectations, and meets the contractual requirements regarding compliance and procurement reviews of federal grant programs, including the National School Lunch Program (NSLP), Child and Adult Care Program (CACFP), Summer Food Service Program (SFSP), and Seamless Summer Option (SSO) administrative reviews. Position Requirements: Coordinate and oversee all aspects of project execution, ensuring adherence to schedules and specifications. Ensure compliance...

Job Description Job Description Summary: The Senior Compliance Auditor is primarily responsible for audit execution on dedicated Regulatory Compliance audits as well as provide coverage during Bank integrated audits. The Senior Compliance Auditor will develop new audit programs when needed; evaluate internal controls and determines effectiveness; review and assess the Bank's operations to ensure they adhere to all applicable laws, regulations, and internal policies, including conducting audits to identify potential compliance risks, investigating issues, and recommending corrective actions to maintain regulatory compliance within the banking industry; typically requiring strong analytical skills, knowledge of banking regulations (like BSA/AML), and attention to detail to identify potential areas of non-compliance. Job Responsibilities: Audit Responsibilities Coordinate within a framework established by the Internal Audit Manager, and performs regular reviews of Bank...