1532 provider coding compliance auditor jobs found

Baylor Scott & White Health (BSWH) is seeking a Provider Coding Compliance Consultant to support the organization's compliance program. The role reports to the Coding Compliance Manager and helps develop, implement, and maintain BSWH policies to ensure adherence to federal, state, and local laws and regulations. The position involves identifying audit projects, conducting provider service audits, generating reports with actionable guidance, obtaining corrective action plans, and coordinating #J-18808-Ljbffr

Baylor Scott & White Health (BSWH) is seeking a Provider Coding Compliance Consultant to join the Compliance team. The role reports to the Coding Compliance Manager and supports developing and maintaining BSWH policies to ensure adherence to federal, state, and local laws and regulations. The position offers a pay range from $30.52/hour ($63,481/year) up to $45.79/hour ($95,243/year), depending on qualifications and experience. #J-18808-Ljbffr

Baylor Scott & White Health (BSWH) seeks a Provider Coding Compliance Consultant to support the compliance program. The role reports to the Coding Compliance Manager and works with the Compliance VP/Director to develop, implement, and maintain BSWH policies in line with federal, state, and local laws. The position emphasizes auditing provider services, documenting findings, and improving compliance effectiveness. Strong communication and CPT/ICD-10-CM expertise are essential. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Provider Coding Compliance Consultant to support the Coding Compliance Manager and VP/Director. You will help develop, implement, and maintain BSWH policies ensuring adherence to laws and regulations across the system. Responsibilities include auditing projects, educating providers on compliance trends, and coordinating corrective actions. Strong communication, detail orientation, and CPT/ICD-10-CM knowledge are essential. #J-18808-Ljbffr

Coding AuditorAllCare Health | Quality Department | Grants Pass, OregonSummary of the PositionThe Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members.This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes.Essential DutiesEnsures the accuracy and correlation of diagnosis codes, dates of service, medical record documentation, and other information used to support risk adjustment.Identifies, analyzes, and communicates trends related to coding accuracy and documentation quality.Develops and supports intervention...

Job Details Job Location: Reno, OH 45750Position Type: Full TimeJob Shift: 8-Hour Day ShiftJob Category: Professional In an environment of continuous quality improvement, the Coding Auditor will assist in the review of medical records documentation to ensure completeness, accuracy, and compliance with applicable federal and state regulations and guidelines. The Coding Auditor will also be responsible for all documentation and coding education that is provided to the coding staff and providers. Exhibits the Standards of Excellence and exercises strict confidentiality at all times. Job Functions Manages quality improvement audits and training of designated coding staff and providers. Researches, analyzes, and responds to internal and external inquiries regarding compliance, inappropriate coding, denials, and billable services. Acts as expert coding resource to coders, clinical documentation improvement, providers, and other departments within the hospital or provider clinics....

Overview The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team. Essential Duties Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed Reviews...

Job Description Job Description Company Description More Than Just Care, It’s Community   Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.   If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be  Munson Material.  To us, that means teammates who live by our values of  excellence, teamness, positivity, creativity,  and a commitment to creating  exceptional experiences  for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country. Invested in You   Grow:  Tuition reimbursement, in-person and online development, and access to our career hub to...

Coding AuditorOSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Expected pay for this position is $29.01 - $34.13/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position.Position SummaryThe Coding Auditor is responsible for performing coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services. Provides validation of accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers; ensuring coding quality standards are achieved and maintained. Responds to external coding audits and DRG billing denials, writing appeals, documenting coding rationale and defends OSF coded...

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...

PACT MSO, LLC is seeking an experienced Medical Coding Auditor in Branford, CT, to conduct medical billing, coding, and documentation audits to ensure regulatory and payer compliance. The role analyzes provider documentation, coding accuracy, and revenue cycle processes across specialties, and provides education and recommendations to clinicians and staff to improve accuracy and compliance. Monday–Friday, 8:30am–5:00pm; not remote. #J-18808-Ljbffr

WellStreet Urgent Care is redefining the urgent care experience through patient-focused service, high-quality care, and strong partnerships with health systems. As a rapidly growing healthcare organization, we are building a national network of urgent care facilities and creating opportunities for talented professionals to make a meaningful impact. If you're an experienced medical coder who enjoys digging into documentation, identifying coding opportunities, and helping providers and coding teams improve accuracy, this could be a great opportunity to join our team. About the Role The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes. This role goes beyond identifying errors—you'll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement. What You'll...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Overview Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. POSITION SUMMARY: The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team's broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

## Compliance AuditorApplylocations: MHC Nashville, TNtime type: Full timeposted on: Posted Todayjob requisition id: JR102201Ranked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee.Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis.If you are interested in joining a team that is caring, collaborative, innovative...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Medical Coding Auditor Hybrid (1 - 2 days in office per week) Baltimore, MD 21201 Compensation $66k-$92k Direct Placement Description Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Core Responsibilities Conduct independent physician coding and auditing reviews to assess the adequacy of medical record documentation supporting codes selected by providers and/or coders. Perform detailed physician coding compliance audits to ensure adherence...

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...