1143 insurance compliance auditor jobs found

Job Description Job Description Hiring: Insurance Compliance Auditor Company: Information Providers, Inc. Location: Wichita, KS At Information Providers Inc. (IPI), we believe great work starts with great people. Since 1996, we've established ourselves as a leader in Property & Casualty and Premium Audit information services, serving insurance companies nationwide through innovative technology and experienced professionals. With over 430 employees and a unique field force supported by regional offices, we deliver accurate, high-quality information. Our core values, service, reliability, flexibility, timeliness, and innovation, drive our growth and foster a supportive workplace. At IPI, your ideas matter, your growth is supported through mentorship and opportunity, and your contributions make a meaningful impact every day. Join us and be part of a team that values its people as much as its purpose! What You'll Do As Our Full-time Insurance Compliance...

Build a career where your precision and decisions truly matter. Information Providers Inc. in Minneapolis, MN, and Bloomington, MN, is hiring a full-time Insurance Premium Auditor . Apply now and take the next step forward in your career. You can expect to earn $42,000-$55,000 per year , along with a comprehensive benefits package that includes: Health, dental, and vision insurance PTO Flexible schedule Growth opportunities HSA/FSA Life insurance Short- and long-term disability 401(k) As our Insurance Premium Auditor, you will also receive a company-provided laptop. WHEN YOU'LL WORK Choose a schedule that supports your lifestyle while maintaining a consistent routine. We offer full-time opportunities, working either 8 am‑5 pm or 7 am‑4 pm, Monday through Friday. What Your Day Entails You will dispatch directly from your home to your assigned job sites, taking ownership of your daily schedule by coordinating and managing client appointments. You will conduct both...

Build a career where your precision and decisions truly matter. Information Providers Inc. in Indianapolis, IN, is hiring a full-time Insurance Premium Auditor . Apply now and take the next step forward in your career. You can expect to earn $42,000-$55,000 per year , along with a comprehensive benefits package that includes: Health, dental, and vision insurance PTO Flexible schedule Growth opportunities HSA/FSA Life insurance Short- and long-term disability 401(k) As our Insurance Premium Auditor, you will also receive a company-provided laptop. WHEN YOU'LL WORK Choose a schedule that supports your lifestyle while maintaining a consistent routine. We offer full-time opportunities, working either 8 am-5 pm or 7 am-4 pm, Monday through Friday. What Your Day Entails You will dispatch directly from your home to your assigned job sites, taking ownership of your daily schedule by coordinating and managing client appointments. You will conduct both in-person and virtual...

Univista Holdings in Miami, FL is seeking an Auditor/Compliance Specialist to ensure adherence to company policies, industry regulations, and internal standards. The role combines traditional auditing with evaluating operations, processes, and documentation. The ideal candidate has experience in insurance auditing (auto/home preferred), strong analytical skills, and proficiency with Microsoft Office and audit software. #J-18808-Ljbffr

FlexStaff is seeking a Compliance Auditor to work for one of our external clients, a non-profit organization that provides home healthcare services to the elderly, disabled and chronically ill in the New York metropolitan area. This is a temporary 13-weeks contract with possibility to become permanent. Schedule: Monday - Friday 8:30am-5:30pm, (1 hour lunch) In this role you will be responsible for performing internal and external auditing functions for the Compliance Department. Requirements: Bachelor’s degree in health care administration, political science, social science or related field required. Experience with PACE, Part D, LHCSA and Article 28 requirements Minimum of three (3) years Healthcare Audit background preferably in a Health Insurance Plan Understanding of Medicare and Medicaid programs is strongly preferred. Responsibilities include, but not limited to: Support enterprise-wide risk assessments and the annual compliance audit plan Develop and perform...

Wakefern Food Corp. is the largest retailer-owned cooperative in the United States and supports its co-operative members' retail operations, trading under the ShopRite®, Price Rite®, The Fresh Grocer®, Dearborn Markets®, Fairway Markets®, Gourmet Garage®, and Morton Williams® banners. Employing an innovative approach to wholesale business services, Wakefern focuses on helping the independent retailer compete in a big business world. Providing the tools entrepreneurs need to stay a step ahead of the competition, Wakefern’s co-operative members benefit from the company’s extensive portfolio of services, including innovative technology, private label development, and best in class procurement practices. The Quality Assurance Supplier Compliance Auditor is responsible for managing compliance programs for Wakefern Own Brands suppliers. This role develops and maintains an approved supplier program based on regulatory and corporate requirements to mitigate risk and ensure Wakefern and its...

Job Description Job Description About us Community Health Plan of Imperial Valley (CHPIV) is committed to improving the health and well-being of our community by offering accessible, high-quality, and culturally sensitive healthcare services. We are a local health plan dedicated to making a positive impact through education, outreach, and innovative care.The Compliance Auditor plays a critical role in advancing the mission of Community Health Plan of Imperial Valley (CHPIV) by ensuring that administrative/non-clinical functions performed by delegated entities are in full compliance with regulatory, contractual, and clinical standards. About the role Our new Compliance Auditor will do the following: Evaluate process compliance and operational workflows for internal and delegated functions. Identify systemic issues and contribute to corrective action planning. Monitor regulatory metrics and reporting to committees. Conduct audits of non-clinical delegated functions...

Position SummaryThe Coding Auditor is responsible for performing comprehensive coding audits to ensure accuracy, compliance, and consistency across all professional services at VMG. This role supports service-line transitions, vendor oversight, and quality validation.Each Coding Auditor will be aligned to a Coding Educator to ensure coordinated education and quality improvement efforts.EducationHigh school diploma or equivalent required.ExperienceMinimum of 5 years of professional coding experienceCertified Professional Coder (CPC) – AAPC required or equivalentMulti-specialty experience in professional codingStrong presentation and communication skillsCPC-H (Hospital Outpatient) preferredCPMA (Certified Professional Medical Auditor) preferredSkillsAdvanced knowledge of coding guidelines.Strong understanding of professional fee coding, reimbursement methodologies, and revenue cycle operations.Demonstrated expertise in conducting audits and evaluating physician documentation for...

Job Purpose The Coding Auditor will be responsible for inpatient and outpatient coding and auditing for various specialties. This role will also be responsible for preparing and presenting audit results. Duties and Responsibilities Perform coding audits and compliance audits for providers, including physicians and mid‑level providers. Prepare reports of audits and present audits to internal and external parties as needed Complete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance Provide physician education when necessary. This could include, but is not limited to, audit findings or edit and denial trending. Complete coding audits for our copartners’ coding WQ Work with any offsite auditors Evaluate and report on the overall quality of physician documentation that supports selected codes most...

Compliance Auditor – SouthEast Alaska Regional Health Consortium (SEARHC) Pay Range: $47.69 - $67.19 SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more. Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare/Medicaid regulations, federal and state laws, and SEARHC policy. Key Essential Functions and...

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

Coding Auditor And Educator (Remote) Employment Type: Full-Time Shift: Days (Summary) Position Highlights: Competitive pay Additional benefits: tuition reimbursement, free parking, employee discounts Quality of life: flexible work schedules Advancement: professional growth within the organization Location: Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD. Description: Monday-Friday The Professional Coding Auditor Educator performs medical record audits including but not limited to analysis of medical record documentation, validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Responsibilities: Monitors accuracy of centralized coders' charge capture and coding with proper ICD-10, CPTs, as well as proper...

Professional Fee Coding Auditor At NorthBay Health the Professional Fee Coding Auditor is responsible for auditing professional fee coding across all service lines (Ambulatory/Hospitalist, Surgery, and Emergency Medicine), resolving pre-billing coding edits, and reviewing post-billing coding-related denials. This role ensures coding accuracy, documentation integrity, and compliance with CPT, HCPCS, ICD-10-CM, and payer-specific rules. The position supports coding quality improvement, identifies trends, provides coder feedback and physician education based on audit and edit findings, and partners with leadership to strengthen coding workflows across the organization. PRIMARY JOB DUTIES Audit Responsibilities Performs routine and targeted professional fee coding audits across all service lines: Ambulatory/Hospitalist (including Urgent Care and Pools), Surgery, and ED ProFee. Reviews documentation for completeness, accuracy, and compliance with CPT, HCPCS, ICD-10-CM, and payer...

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Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

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...

45225BR Medical Coding Supervisor Centralized Coding Lbk Lubbock Introduction Nationally recognized as a Great College to Work For , TTUHSC provides much more than just a job! Enjoy excellent benefits , including paid leave, retirement plans, wellness programs, health insurance and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? About TTUHSC Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas and beyond. This...

Job Description Job Description Position: Affordable Compliance Auditor and Utility Billing Manager Category: Non-exempt - Hourly Supervisor: VP of Operations Location: Sandy, UT Office (on-site, full-time) Hours: Full Time: 5 days per week, 8 hours per day (average 40 hours). Typical range of hours is based on community needs and may be adjusted accordingly. Physical Demands: Light (occasional up to 25 pounds) - Climb stairs, stoop, kneel, crouch, reach, handle, etc. Drug Screens: Pre-employment, post injury, reasonable suspicion, and possible random screens. At New Earth Residential we believe in the power of community. General Summary of Associate Responsibility The Affordable Compliance Auditor and Utility Billing Manager audits affordable compliance files for site teams and instructs onsite team members on compliance file procedures, while also owning GreenPay utility billing operations — setting up and offboarding utility accounts, processing invoices, and reconciling...

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...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Job Description Job Description Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines, coverage policies and regulatory and contract requirements. Qualifications:  Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of...

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...