448 healthcare coding compliance auditor jobs found

Coding Compliance Auditor (Administrative Services Manager I) Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations. Key Responsibilities: Conduct thorough reviews of medical records for compliance with coding regulations Provide feedback and education to coders and physicians to improve coding accuracy and documentation Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries Support ongoing program development through training initiatives and process improvements Deliver coding presentations to diverse audiences, including physicians May supervise...

Salary : $101,536.34 - $139,533.58 Annually Location : Riverside Job Type: Regular Job Number: 25-74191-01 AL Department: RUHS-Medical Center Opening Date: 09/09/2025 Closing Date: Continuous ABOUT THE POSITION Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations. Key Responsibilities: Conduct thorough reviews of medical records for compliance with coding regulations Provide feedback and education to coders and physicians to improve coding accuracy and documentation Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Welbehealth Pace Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...

Coding Compliance Auditor Job Summary: HIM Coding auditor/trainer will coordinate, monitor, and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-10, ICD-9-CM, HCPSC codes and clinician documentation to ensure that Kaiser Permanente is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities. The auditor will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, this position will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, Revenue Cycle, External and Internal practitioners, and other regional departments...

Job Description Job Description Description: Seeking a detail-oriented and knowledgeable Provider/Coding Auditor Educator to support accurate and compliant coding practices across our provider network. This role will be responsible for performing audits of medical documentation and coding, educating providers on best practices, and ensuring adherence to industry guidelines and payer regulations. The ideal candidate is a certified coding professional with strong communication skills and a passion for education and compliance. This role requires flexibility to travel 50% of the time to various provider locations in the State of Georgia for onsite education and auditing support, as needed Requirements: Key Responsibilities Conduct prospective, concurrent, and retrospective coding audits for professional and/or facility services. Review medical documentation to ensure codes assigned (ICD-10-CM, CPT, HCPCS) are supported and meet regulatory and payer guidelines. Deliver coding...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Welbehealth Pace Program WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure reviews. Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release of information. Maintain current...

A non-profit health organization based in Alaska is looking for a Compliance Auditor to ensure compliance with healthcare regulations and coding requirements. The role involves conducting audits, analyzing data for compliance issues, and preparing detailed reports. Ideal candidates will have at least three years of experience in compliance auditing and relevant certifications. This position offers a comprehensive benefits package including retirement, paid time off, health insurance, and more. #J-18808-Ljbffr

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. 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 confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Physician Coding Auditor This is a full-time, remote position that offers a flexible schedule. Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coding Auditor is expected to adhere to MedKoder's internal coding/auditing policies and expectations set forth by department management. Physician Coding Auditor must prioritize daily duties, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. Candidates ideally have recent auditing experience specializing in some of the following profee areas: Ophthalmology, Behavioral Health, Cardiovascular/Cardiothoracic Surgery, Complex ENT Surgery, Dental, Complex Plastic Surgery, Orthopedic Surgery, Peds...

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...

Job Title Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary...

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...