1294 provider coding compliance auditor jobs found

Baylor Scott & White Health (BSWH) seeks a Provider Coding Compliance Consultant to develop, implement, and maintain policies ensuring compliance with federal, state, and local laws. The role reports to the Coding Compliance Manager and works with Compliance VP or Director. Key duties include identifying audit projects, conducting audits of provider services, preparing reports, obtaining corrective actions, tracking findings, and educating providers on coding practices and compliance trends. #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

Professional Coding AuditorWellStreet 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.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.Perform...

Enterprise Compliance Auditor/EducatorThe Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance.Minimum Qualifications:Education, Certification, Experience, and/or Licensure:1. High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR;Associate's Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding.2. Current certification in one of the following:Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC)Registered Health Information Technician...

Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and...

A healthcare provider is seeking a Coder Auditor-Professional to audit coding assignments and train staff. The ideal candidate will hold a high school diploma and relevant certifications, with a focus on coding accuracy and quality audits. Responsibilities include conducting audits, assisting coders, and ensuring compliance with coding standards. This full-time hybrid position offers compensation between $23.87 and $37.00 based on experience, along with opportunities for career development and education support. #J-18808-Ljbffr

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 reimbursement...

Facility Inpatient Coding Audit Team Lead GeBBS Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping healthcare organizations optimize operations, improve financial performance, maintain compliance, and enhance the patient experience. Recognized as a KLAS® Top Performer, GeBBS combines innovative technology, industry expertise, and a commitment to excellence to deliver measurable results for clients across the healthcare industry. We are dedicated to being a trusted healthcare partner by upholding the highest standards of quality, information security, and compliance. At GeBBS, we foster a collaborative and growth-oriented culture where employees are empowered to develop their skills, advance their careers, and make a meaningful impact in transforming healthcare. GeBBS Healthcare Solutions is seeking an experienced Facility Inpatient Coding Audit Team Lead to provide both technical leadership and hands-on auditing...

Ranked 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 and energizing this might be a great place for you! Job Title: Compliance Auditor Department: Compliance Reports To: Director of...

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 reimbursement...

A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced knowledge of outpatient coding and payment methodologies, along with at least 3 years of relevant experience. The position offers competitive salary options and comprehensive benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr

Compliance Medical Auditor and Educator Hourly Compensation Range: $24.00 - $26.00 per hour Employment Type: Full-time, benefit eligible Job Field: Healthcare Compliance Location: Remote Travel: 0-10% We are seeking a detail-oriented Compliance Medical Auditor and Educator to support coding, billing, documentation, and regulatory compliance for OB hospitalist services. In this remote healthcare compliance role, you will perform professional billing and coding audits, review medical record documentation, deliver provider education, and help strengthen compliant coding practices across the organization. This is an excellent opportunity for a Certified Professional Coder or experienced healthcare compliance professional who enjoys auditing medical records, interpreting coding guidelines, educating physicians and staff, and translating complex compliance requirements into clear, actionable guidance. What You Will Do: Conduct billing and coding compliance audits, which may...

Professional Fee Coding Auditor & EducatorWe are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role.The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities,...

Coding AuditorAdventist Healthcare's Support Center seeks to hire an experienced Coding Auditor for our Revenue Integrity department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Coding Auditor, you will:Lead discussions and educational sessions, with manager support, with various impacted Revenue Integrity stakeholders to improve overall revenue goals and departmental needs.Analyze and resolve billing edits and bill holds for areas impacted by coding.Manage assigned work queues and associated tasks to review, analyze, and provide corrective action.Maintain work queues at agreed-upon levels to keep on task with department goals and objectives.Escalate barriers or concerns to the manager in a timely, clearly articulated and documented format.Perform EHR analyses and research along with associated patient accounting, medical charting, and system interfacing to examine and understand underlying root causes of...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Employment Type: Full time Shift: Description: Purpose Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge. Note: “patients” refers to patients, clients, residents, participants, customers, members Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency &...

Join Our Caring Community Humana, a Fortune 100 Company, is looking for an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities...

A healthcare provider in Chicago is seeking a Compliance Auditor to perform audits on provider documentation and coding. Responsibilities include managing compliance issues and communicating effectively with providers regarding results. Candidates should have a Bachelor's Degree and relevant certifications like RHIA or CPC. Strong interpersonal skills and experience in healthcare compliance are preferred. This role offers competitive benefits and opportunities for professional growth. #J-18808-Ljbffr

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for improvement...

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 reimbursement...