187 healthcare systems revenue cycle compliance auditor jobs found

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...

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 rapidly changing healthcare...

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...

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking. We are seeking an experienced Medical Coding Auditor to support our continued growth and commitment to deliver exceptional client outcomes. Why Join Us? Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most. Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support. A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk-taking and continuous...

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...

Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking. We are seeking an experienced Medical Coding Auditor to support our continued growth and commitment to deliver exceptional client outcomes. Why Join Us? Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most. Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support. A Culture of Innovation: Have a fresh perspective? We want it. We encourage risk-taking and continuous...

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...

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 rapidly changing healthcare...

Senior Risk Adjustment Coder 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 Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk...

Inpatient Medical Coder Company Overview Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. Summary Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. Mandatory Knowledge And...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)This is a Stanford Health Care - University Healthcare Alliance job.A Brief OverviewThe 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.LocationsStanford Health Care - University Healthcare AllianceWhat you will doRisk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and...

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 rapidly changing healthcare...

Billing/Certified Coder 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. Minimum Qualifications:...

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Auditor Job Summary and Qualifications The Coding Auditor is responsible for performing quality reviews and audits of the assigned staff. This includes coordination with the department managers to ensure standards are met in accordance with department and organization policy. Additionally, this team member contributes to improving the processes and infrastructure of the department. Proficient in facilitation and interpersonal communication, this team member also consistently demonstrates skills in organization, prioritization, professionalism and coaching others. What you will do in this role: Perform regularly-scheduled quality reviews...

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 as appropriate including...

Position Summary The Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine audits, focused audits, for cause audits and, not for cause audits for Chesapeake Regional Healthcare (CRH) and all of its affiliated entities. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure corrective action and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on the interpretation and application of...

Health Business Solutions (HBIZ), founded in 2002, is a high-impact, transitional outsourcing firm that provides near-term relief to overturn denied claims and accelerate cash while concurrently working with providers and health systems to address Revenue Cycle under-performance. The Coding Auditor will perform detailed reviews of medical documentation and coding, ensuring accuracy, compliance with coding standards, and adherence to regulations such as ICD-10, CPT, and HCPCS. The auditor will work closely with coding teams, providers, and clinical staff to educate on coding practices and provide feedback for continuous improvement. Key Responsibilities Review and Audit Medical Records : Conduct audits of medical records to ensure that coding is accurate, compliant with payer requirements, and adheres to national coding guidelines (ICD-10, CPT, and HCPCS codes). Ensure Regulatory Compliance : Ensure all medical coding aligns with applicable federal, state, and local laws and...

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

To support a growing compliance team, the full-time Washington Licensed Compliance Auditor will conduct audits to evaluate adherence to Federal and State laws, regulatory rules, and internal policies while working remotely. Key responsibilities Conduct audits across various revenue cycle departments, focusing on compliance with laws and regulations Analyze data from Clinical EMR and Epic Billing systems, reviewing charges, codes, and supporting documentation Present audit findings collaboratively to reduce risk and ensure compliance within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant experience in hospital billing auditing or coding 5 years of recent experience in hospital billing auditing or hospital coding

To support compliance initiatives, the full-time California Licensed Compliance Auditor will conduct audits evaluating adherence to federal and state regulations, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits on clinical and non-clinical services to ensure compliance with regulations and internal policies Analyze data from Clinical EMR and Epic Billing systems, identifying discrepancies and ensuring accuracy in billing practices Collaborate with various departments to present audit findings and contribute to risk reduction efforts Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of relevant hospital billing auditing experience 5 years of recent experience in hospital billing auditing or coding

Working remotely, the full-time salaried Compliance Auditor will conduct audits to evaluate compliance with federal and state regulations, focusing on revenue cycle departments and clinical documentation while collaborating with various teams to present findings aimed at reducing risk. Key responsibilities Conduct audits of clinical and non-clinical services to ensure compliance with relevant regulations and policies Analyze data from Clinical EMR and Epic Billing systems, reviewing charges, codes, and supporting documentation for accuracy Present audit findings collaboratively to stakeholders, aiming to mitigate risks within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a related field, or 5 years of recent hospital billing auditing or coding experience 5 years of recent hospital billing auditing or coding experience

To support compliance efforts, the full-time Oregon Licensed Compliance Auditor will conduct audits to evaluate adherence to Federal and State laws, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits across clinical and non-clinical services, including revenue cycle departments and billing offices Analyze data from Clinical EMR and Epic Billing systems to ensure accuracy and compliance Present audit findings collaboratively to reduce risk within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a similar field, or 5 years of relevant auditing experience 5 years of recent experience in Hospital billing auditing or Hospital coding

To support compliance efforts, the full-time New Mexico Licensed Compliance Auditor will conduct audits on clinical and non-clinical services, focusing on revenue cycle processes while working remotely. Key responsibilities Conduct audits to evaluate compliance with federal and state regulations, as well as internal policies Analyze data across Clinical EMR and Epic Billing systems, reviewing line-item charges and supporting documentation Present audit findings collaboratively to reduce compliance risks within the organization Required qualifications Bachelor's Degree in Business, Healthcare, Finance, or a similar field, or 5 years of relevant hospital billing auditing experience 5 years of recent hospital billing auditing or hospital coding experience