651 healthcare compliance auditor jobs found

We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at either the Consultant or Managing Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular...

A healthcare organization in California is seeking a Compliance Auditor to support compliance and quality programs through audits and data validation. The ideal candidate will have a Bachelor's degree in health care administration and at least 2-4 years of experience in healthcare compliance. Responsibilities include conducting audits, producing reports, and identifying risks to ensure continuous improvement in compliance and patient safety. This role offers a competitive salary and a comprehensive benefits package. #J-18808-Ljbffr

A leading health care provider in New Jersey seeks a mid-senior level auditor to conduct compliance reviews of professional fee billing and coding. The ideal candidate will have over 3 years of experience, demonstrate expertise in medical terminology and healthcare coding, and possess a current CPC or COC certification. This full-time position offers a chance to contribute to maintaining high compliance standards within the organization while supporting the growth and development of health services. #J-18808-Ljbffr

A healthcare organization in California is seeking a 340B Program Auditor responsible for auditing 340B prescription claims and ensuring compliance with federal regulations. This full-time role includes verifying patient eligibility, conducting audits, and maintaining compliance documentation. Ideal candidates should have experience in healthcare auditing and relevant certifications. Competitive salary is offered along with a focus on a supportive work environment. #J-18808-Ljbffr

Job Description Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

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...

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...

Healthcare Compliance Specialist/Auditor Join a purpose-driven team at Caron Treatment Centers, where for nearly 70 years, we've been helping people find a path to recovery from addiction and rebuild their lives. We offer real careers with real opportunities for growth, comprehensive training, and a commitment to work-life balance. Our benefits include generous paid time off, company-paid life and disability insurance, professional growth and development, tuition reimbursement, a competitive 401(k) plan, and robust medical, dental, and vision plans. We're proud to foster a diverse and inclusive environment, with a culture of teamwork, compassion, and dedication to our mission. Start a career that saves lives at a company that values yours! Position will be full time, working Monday-Friday 8:30-5pm. Candidates can work a hybrid schedule, with a few days in office each week at our Wernersville or Delray Beach campus. Must also be available on-site during audits. Duties and...

Job Description Job Description Are you the missing piece in protecting America’s safety net? We don’t just hire talent—we build purpose-driven teams. At ERN Enterprises, we stand in the gap for emergency safety net providers and the patients they serve. We hold health plans accountable. We speak up for those who can’t, and we’re looking for more than just a resume—we’re looking for you. ERN in the news: https://youtu.be/mw1TQhVFBKk The Mission Our Healthcare Claims Compliance Auditors are warriors for justice in Revenue Cycle Management. You’ll analyze unfair trends, initiate corrective actions, support prelitigation strategy, and make sure regulatory timelines are honored—not ignored. You’ll change lives and challenge systems. Do You Belong Here? We’re looking for people with: Competency – Do you have the skills or the hunger to learn them? Character – Are you ethical, reliable, and honest—even when no one’s watching? Chemistry – Can you collaborate, communicate,...

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

Join a purpose-driven team at Caron Treatment Centers, where for nearly 70 years, we’ve been helping people find a path to recovery from addiction and rebuild their lives. We offer real careers with real opportunities for growth, comprehensive training, and a commitment to work-life balance. Our benefits include generous paid time off, company-paid life and disability insurance, professional growth and development, tuition reimbursement, a competitive 401(k) plan, and robust medical, dental, and vision plans. We’re proud to foster a diverse and inclusive environment, with a culture of teamwork, compassion, and dedication to our mission. Start a career that saves lives at a company that values yours! Position will be full time, working Monday-Friday 8:30-5pm. Candidates can work a hybrid schedule, with a few days in office each week at our Wernersville or Delray Beach campus. Must also be available on-site during audits. Duties and Responsibilities: Conduct audits in areas...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land...

About Us At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs.  Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description The auditor reviews professional fee billing, coding and documentation.  Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses.  Customers include employed providers,...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Coding Auditor at AllCare Health AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position: This position is responsible for the development, implementation, and maintenance of auditing practices related to medical record coding and documentation, with the objective of capturing accurate and complete risk adjustment outcomes for Medicare members leading to an increased level of care. The risk adjustment coder ensures that member medical records are following the Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation procedures by performing the following duties. Essential Duties: Ensuring the accuracy and correlation of diagnosis codes, dates of service, and chart notes. Identifying and communicating trends related to coding and documentation quality. Formulating intervention strategies for healthcare...

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. 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...

Become a part of our caring community and help us put health first The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

divh2Inpatient Medical Coding Auditor/h2pBecome a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment./ppIf you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by...

Become a part of our caring community and help us put health first The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. Job Summary The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers. The Senior Clinical Compliance Auditor collaborates with...