529 healthcare compliance auditor jobs found

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...

Senior Risk Adjustment Coder (CPC, CRC, and CCDS required) Stanford Medicine Partners Newark, CA (Remote/CA Resident) Stanford Medicine Partners (SMP) is looking for an amazing Senior Risk Adjustment Coder to join our rapidly growing team! SMP prides itself in offering exceptional service and patient care. Stanford Medicine Partners with Stanford Health Care to provide individualized and convenient care with access to Stanford specialists and technology. Join our team and start making a difference today! A Brief Overview The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do Risk Adjustment...

University Health is one of the largest employers in San Antonio. We are a nationally recognized teaching hospital and consistently recognized as a leader in advanced treatment options, new technologies and clinical research. Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery. We are currently looking for a talented health professional to join our team as a Coding Educator & Auditor for our Revenue Integrity department . This is an exciting opportunity to join a company with a reputation for exceptional service and patient care.   The Position : Works under the direct supervision of the Coding Education & Audit Manager. Will perform any or a combination of the following types of coding education and audit: Basic ancillary services, Emergency Room services, Hospital Observation, Ambulatory surgery, Inpatient Admission. Utilizes the ICD-10-CM and CPT coding...

AMBULATORY (Same Day Surgery) OUTPATIENT CODER ON SITE Joint Base Andrews, MD ABOUT US: Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world.   LTSI connects the right people to the right opportunity.  With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical services. Our goal is to provide the highest quality of professionals in the industry. LTSI’s culture delivers a strong work ethic while going above and beyond with a sense of urgency. We are the employee-driven company.  We strive for excellence every day, which is what sets us apart from all the other government contractors. Our strong work ethic, sense of urgency and commitment to going above and beyond for our clients is what we value most!   As a Certified...

Farragut Square Group provides clients with research and policy advisory services on a range of healthcare topics, including Billing and Coding Claims reviews of physician office practices and in and out-patient facilities.  As part of our ongoing commitment to be #AlwaysBetter for our people, clients, and communities, we have created a culture of belonging that champions your individuality and authenticity as both a person and a professional. From our competitive compensation, top benefits and award-winning professional development programs to industry-leading wellness initiatives, we support you through every stage of your life and career so you can live a life you love both in and outside of the office. With us, you’ll find: A Firm where everyone belongs: Our award-winning culture prioritizes warmth and authenticity — we encourage you to be yourself! Enthusiasm for diverse perspectives: We’re smarter and stronger when everyone has a voice and...

We are seeking an experienced and detail-oriented Billing Manager/Revenue Cycle Manager to join our orthopaedic surgery practice. This key leadership position will be responsible for overseeing all aspects of our revenue cycle operations, from insurance verification through payment posting and collections. The ideal candidate will have extensive experience in healthcare billing, particularly in orthopaedic or other surgical specialty practice settings, with a strong understanding of medical coding, insurance reimbursement, and revenue cycle optimization. This position plays a critical role in ensuring the financial health and sustainability of our practice by maximizing revenue capture and minimizing payment delays. As the Billing Manager, you will directly supervise all billing staff members and work closely with practice leadership to ensure financial stability and growth through efficient revenue cycle processes. This role requires exceptional analytical skills, leadership...

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, were 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 will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and...