Physician compliance auditor jobs

Physician Coding Compliance Auditor - Professional Billing - Hybrid - FTE - Days

Grady Health System Atlanta, GA, USA

Overview Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. Summary The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal stakeholders...

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Remote Physician Coding Educator & Compliance Auditor

Grade Health System Atlanta, GA, USA

A healthcare organization based in Atlanta is seeking a Physician Compliance Auditor to conduct audits, report findings, and lead training sessions on coding and billing. The ideal candidate will possess at least five years of coding experience, with a strong organizational skill set and effective communication abilities. Preferred qualifications include a Certified Professional Coder certification and experience in auditing. Join a team committed to ensuring compliance and excellence in healthcare billing processes. #J-18808-Ljbffr

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Physician and Professional Coding and Compliance Auditor-Corp. Compliance

Baptist Health Little Rock, AR, USA

Department: Corp. Compliance Shift: Day Working Hours: Monday-Friday 8am-5pm Summary: The Professional and Physician Coding Compliance Auditor conducts and completes audits for medical necessity and/or documentation accuracy, ensuring compliance with federal regulations and guidelines. The Compliance Auditor also conducts and completes audits related to professional coding. Other information: MINIMUM REQUIREMENTS 1. Certified Professional Coding certificate is required 2. A minimum of 3 years experience in chart auditing/medical review is required 3. Expert knowledge of documentation and professional coding guidelines, as well as governmental reimbursement laws and regulations. 4. Good oral and written communication skills 5. Strong interpersonal skills with the ability to work independently. 6. Highly organized, detail oriented, and able to establish work priorities. 7. Registered Nursing license is preferred. This job will be authorized 80.00 hours bi-weekly.

BH

Physician Coding & Compliance Auditor — Expert Reviewer

Baptist Health Arkansas Little Rock, AR, USA

A comprehensive healthcare organization in Little Rock is seeking a Physician and Professional Coding and Compliance Auditor. The role involves conducting audits for medical necessity and documentation accuracy to ensure compliance with federal regulations. Ideal candidates should possess a Certified Professional Coding certificate and have at least 3 years of experience in chart auditing. Strong communication and organizational skills are critical for success in this position. #J-18808-Ljbffr

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Physician and Professional Coding and Compliance Auditor-Corp. Compliance

Baptist Health Arkansas Little Rock, AR, USA

PLEASE NOTE: If you have not applied before, you will need to first create an account after clicking "Apply" Physician and Professional Coding and Compliance Auditor-Corp. Compliance The Professional and Physician Coding Compliance Auditor conducts and completes audits for medical necessity and/or documentation accuracy, ensuring compliance with federal regulations and guidelines. The Compliance Auditor also conducts and completes audits related to professional coding. Other information: MINIMUM REQUIREMENTS Certified Professional Coding certificate is required A minimum of 3 years experience in chart auditing/medical review is required Expert knowledge of documentation and professional coding guidelines, as well as governmental reimbursement laws and regulations. Good oral and written communication skills Strong interpersonal skills with the ability to work independently. Highly organized, detail oriented, and able to establish work priorities. Registered Nursing license...

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Remote Physician Coding Auditor – Compliance & Quality

Orlando Health Orlando, FL, USA

A healthcare organization is seeking a Physician Coding Auditor to perform coding audits, ensuring compliance and efficiency. The role involves analyzing physician and coder charges, monitoring audit results, and collaborating with education teams. Candidates must have a high school diploma, coding certification, and at least 5 years of professional coding experience. Strong communication and organizational skills are essential. The position is remote, allowing flexibility in work location. #J-18808-Ljbffr

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Physician Billing Compliance Auditor

University of Florida Jacksonville Physicians, Inc. Jacksonville, FL, USA

A medical group in Jacksonville is seeking a Physician Billing Compliance Analyst to conduct audits on physician coding and documentation. The role involves analyzing audit findings, coordinating training, and assisting in compliance development. Candidates need a high school diploma, coding certifications, and years of experience in medical billing and auditing. The position offers a chance to ensure adherence to billing regulations in a dynamic healthcare environment. #J-18808-Ljbffr

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Full Time

Healthcare Coding Compliance Auditor

Riverside University Health System Medical Center Hybrid (Riverside, CA, USA)

Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

Full Time

Quality Analyst / Coding Auditor I

Physicians Choice LLC Remote

Physicians' Choice is currently seeking a highly proficient and seasoned Medical Coding Auditor specializing in Evaluation and Management (E/M) services, with a comprehensive understanding of Emergency Medicine, to join our esteemed team. If you possess extensive expertise in current E/M coding guidelines and have a strong background in auditing, we invite you to apply for this exceptional opportunity. Job Description: As a Medical Coding Auditor you will play a vital role in ensuring accurate and compliant coding practices within our organization. You will be responsible for conducting detailed audits of medical records, coding documentation, and related billing processes to verify compliance with established coding guidelines, regulatory requirements, and internal policies. Responsibilities: Perform comprehensive audits of medical records, coding documentation, and billing processes. Evaluate the accuracy, completeness, and appropriateness of medical...

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Full Time

Healthcare Compliance Audit Analyst (Must have CPC, CCS-P, or CPMA)

U.S. Urology Partners Remote

General Summary: U.S. Urology Partners, LLC (USUP) and its physician groups are committed to promoting conduct that is responsible, ethically sound, and compliance with applicable law. USUP’s Compliance Department (CD) fosters a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws and regulations that govern the delivery and reimbursement of health care. An integral function of USUP’s compliance program is auditing and monitoring compliance with billing, coding, and documentation requirements of its providers. An CPC, CCS-P, or CPMA is required for this position. Compliance Audit Services: Compliance audit initiatives include physician, other providers, and facility documentation audits as well as preparation of guidance documents and tools to assist physicians and staff in appropriate billing, coding, and documentation. The audit program looks at professional fee billing,...

AC

Full Time

System Professional Coding Provider Review and Education Manager

Anonymous Company Hybrid

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The System Professional Coding Provider Review and Education Manager is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

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Professional Coding Auditor/Consultant

PYA P C Leawood, KS, USA

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

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Compliance Auditor/Educator - Compliance Quality

Christie Clinic, LLC Champaign, IL, USA

Job Details Job Location : Clark St House (CMC) - Champaign, IL 61820 Position Type : Full Time Education Level : High School Salary Range : $26.69 - $36.69 Hourly Job Shift : 1st Shift Job Category : Coding/Compliance 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 specific samples; and as required. Meet with providers to share audit...

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Professional Coding Auditor/Consultant

PYA P C Knoxville, TN, USA

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

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Coding Auditor-2

Medical University of South Carolina Charleston, SC, USA

Job Description Summary Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC002307 SYS - Hospital Coding Pay Rate Type Hourly Pay Grade Health-26 Scheduled Weekly Hours 40 Work Shift Job Description The Coding Auditor performs provider audits and education per the OC compliance plan policy to ensure compliance with the Federal Documentation Guidelines. This role ensures that claims are coded accurately to optimize reimbursement and has responsibility for keeping physicians and physician assistants current on coding changes and updates. Must have at least one of the following credentials: RHIA, RHIT, CCS or CPC. CPMA preferred. 4 years minimum coding experience required. Additional Job Description Education: Bachelors Degree or equivalent Work Experience: 2-4 years If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The...

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Certified Coder

NEIGHBORHOOD HEALTH CENTER Buffalo, NY, USA

Certified Coder If you believe healthcare is a right, that everyone deserves high quality care so they can enjoy their highest level of health and wellbeing, and you value each person's individual story consider joining us at Neighborhood! As a coder, you'll play an important role in the success of the organization by using your attention to detail, coding knowledge, communication and collaboration skills. You'll use your teamwork skills and training as you review patient medical records, including physician notes, lab results, and procedure details and translate that information into standardized medical codes used for billing insurance companies and maintaining accurate medical records. Responsibilities include: Assigns appropriate medical codes using coding guidelines and reference manuals for diagnoses and procedures Verifies accuracy of coded data by checking for consistency and compliance with coding regulations and insurance standards Communicates with healthcare...

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Professional Coding Auditor/Consultant

PYA P C Brentwood, TN, USA

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

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Medical Coding Auditor Instructor

Highmark Health Washington, DC, USA

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

HH

Medical Coding Auditor Instructor

Highmark Health Raleigh, NC, USA

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

HH

Medical Coding Auditor Instructor

Highmark Health Denver, CO, USA

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

HH

Medical Coding Auditor Instructor

Highmark Health Providence, RI, USA

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

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Medical Coder- Critical Care

AFS Boston, MA, USA

Department Description: The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location: Virtual Job Summary: Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities: Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of...

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Medical Coder- Critical Care

AFS Oklahoma City, OK, USA

Department Description: The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location: Virtual Job Summary: Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities: Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of...

HH

Medical Coding Auditor Instructor

Highmark Health Oklahoma City, OK, USA

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

792 physician compliance auditor jobs found