555 healthcare data quality coding auditor jobs found

CVS Health is seeking a skilled medical records auditor to perform chart reviews and abstract ICD codes for CMS risk adjustment. You will ensure accuracy and compliance with state and federal regulations while supporting coding decisions with evidence from records. Responsibilities include applying guidelines, identifying active vs historical conditions, meeting tight deadlines, and conducting self-audits to maintain quality within our healthcare operations. Strong CPC/CCS-P credentials required. #J-18808-Ljbffr

CVS Health is hiring for a medical records auditor responsible for reviewing and abstracting records, and assigning ICD codes for CMS risk adjustment. You will ensure documentation supports coding decisions and complies with all regulations. Qualified candidates have 1+ year in medical record documentation review or coding, with CPC or CCS-P certification. The role offers a full-time schedule and comprehensive benefits. #J-18808-Ljbffr

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of medical records for CMS risk adjustment, ensuring accuracy and compliance with state and federal regulations and internal policies. Requirements include a minimum of 1 year of related experience and CPC or CCS-P certification, with a high school diploma. The role is full-time, 40 hours per week, in Arizona, with comprehensive medical, dental and vision benefits and paid time off. #J-18808-Ljbffr

CVS Health is seeking a full-time Medical Records Auditor/Abstractor in Oklahoma to review and abstract medical records for CMS risk adjustment. You will ensure accurate ICD coding, validate documentation support, and maintain compliance with state and federal regulations. The role requires 1 year of related experience and CPC/CCS-P certification. We offer a comprehensive benefits package and a 40-hour work week, with compensation based on experience and geography. #J-18808-Ljbffr

CVS Health is seeking a skilled medical records auditor to perform auditing and abstraction of records for ICD coding and CMS risk adjustment. You will ensure codes are accurate and supported by clinical documentation, aligning with state and federal regulations. The role requires CPC/CCS‑P certification, with at least one year of related experience. This full-time position offers comprehensive benefits and the opportunity to contribute to the integrity of health data across care settings. #J-18808-Ljbffr

Job Description - Sr Compliance Auditor (301657) Job Description Sr Compliance Auditor - 301657 Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider‑coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties Conduct audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise...

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Become a part of our caring community 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. Where you Come In 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 accuracy of provider...

Inpatient Coding Auditor Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the...

Job Description Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Revenue Cycle Revenue Integrit Work Type: Full Time (Total FTE between 0.9 and 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $29.36 - $47.79 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary The Billing Coding Auditor uses advanced knowledge of billing, coding, auditing, documentation requirements, and charge capture to solve complex charging...

Job Description Job Description About the Role: The Billing/Certified Coder at Aesthetic Surgery Centre, PLLC plays a critical role in ensuring accurate and efficient medical billing and coding processes that directly impact the financial health of the practice. This position involves meticulously reviewing patient records and surgical documentation to assign appropriate medical codes for procedures and diagnoses in compliance with regulatory standards. The role requires collaboration with clinical staff to clarify documentation and resolve coding discrepancies, thereby optimizing reimbursement and minimizing claim denials. The successful candidate will manage billing submissions, follow up on unpaid claims, and maintain up-to-date knowledge of coding guidelines and payer policies. Ultimately, this position supports the center’s mission by facilitating smooth revenue cycle operations and contributing to high-quality patient care through precise administrative practices....

Overview Department : Medical Records Schedule : Full Time, 40 Hours, Days Facility : Central Maine Medical Center Location : Lewiston, Maine, 04240 Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center  (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute. CMMC also serves as the central Maine base for LifeFlight of Maine, the state's only medical helicopter service. CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities. As part of its...

Description The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Summary Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee vendor‑coding services to...

Compliance Auditor/Educator - Compliance Quality (CPC Required) Clark St House (CMC) - Champaign, IL 61820 Overview Salary Range $28.03 - $38.54 Hourly Position Type Full Time Job Shift 1st Shift Education Level High School Category Coding/Compliance General Summary of Duties Christie Clinic's department of Compliance Quality is seeking a full-time Compliance Auditor/Educator at our Clark Street location in Champaign from Monday-Friday 8:00am-5:00pm, with no night or weekend requirements. Duties include performing ongoing functions related to quality of care and compliance including government and clinic regulations and policies in support of the Christie Clinic Compliance System. Job Qualifications and Expectations JOB DUTIES: (This list may not include all of the duties assigned.) Screen, review, identify and document potential quality and compliance issues. Perform billing and coding audits with both random samples as well as provider and department...

Description Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally on errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This individual must be reliable and maintain a high level of confidentiality within all aspects of job performance. Essential Duties And Responsibilities Assists Coding Manager in developing and maintaining a quality assurance program Performs audits and medical chart reviews contributing to the continual...

Revenue Integrity Auditor Sr. Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate to charging, coding, documentation and billing compliance. This would...

Why work at TidalHealth? Join a triple 'A' rated team where clinical excellence meets a coastal lifestyle. At TidalHealth, you'll be part of an award-winning network spanning Maryland and Delaware, recognized by the Leapfrog Hospital Safety Guide for our unwavering commitment to patient care. Whether your expertise lies in specialized clinical fields like neurosurgery, academic mentorship through our graduate medical programs, or the critical professional and support roles that keep our network thriving, we provide the tools and tuition assistance you need to excel. PB Coding Auditor Position Summary The Coding Compliance Auditor conducts audits of provider documentation. The Auditor is responsible for data quality reviews on provider records to validate the Evaluation and Management (E/M) coding and surgical documentation for professional services. Audits provider records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: Leads,...

Job Description Job Description Description: Full-Time, Remote Temporary Opportunity with Long-Term Potential The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration. Coding Audit & Compliance Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and...

Position Summary Department : Patient Accounting- Physicians Status: Full Time Shift: Remote Location: Orlando, FL Title: Physician Coding Auditor Summary: The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Forbes has named Orlando Health as one of America's Best-In-State Employers. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not...

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members' culture and values. Why Join Us? We're on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Risk Adjustment Coding Auditor is responsible for...

About CLS Health CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians! Summary Assigns and aligns predefined codes, tabulates the data into the computer system, generates new codes, resolves edits and denials, and maintains proper records in accordance with CLS guidance and procedures. Conducts regular reviews to ensure billing is timely, accurate, and in compliance. Job Description Assist with implementing and maintaining system-wide billing and coding quality audits. Understands, interprets and applies coding guidelines for coding audits. Review of medical records to determine coding accuracy of all documented diagnoses and procedures. Reviews claims to validate submitted codes and abstracted data including...

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...