154 quality compliance auditor ii jobs found

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...

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Inpatient/Outpatient Coding Auditor based in the United States. This fully remote role supports healthcare coding quality across multiple medical facilities within a large regional health network. You will independently audit inpatient and outpatient records for coding accuracy, documentation support, compliance, and reimbursement impact. The position combines detailed record review with reporting, quality improvement, and facility-specific education. You will evaluate complex coding across diagnoses, procedures, modifiers, DRGs, bundling rules, and reimbursement requirements. The role offers an opportunity to apply advanced coding expertise in a structured, regulated healthcare environment. You will collaborate with health information management leadership and facility stakeholders while maintaining high standards for accuracy and...

Health Information Management Miami, FL Full-Time Jackson Health System Full Time Summary The HIM Coding Compliance Auditor 1 analyzes abstracted/coded data for the purpose of ensuring accuracy and timeliness as it relates to DNFB management, quarterly AHCA data submissions and PFS communication. Responsibilities Reviews quality of coded and abstracted data assuring coding compliance within the Jackson Health System. Performs target and focused MS-DRG, APC, CPT, Case mix and Medical Necessity reviews. Identifies monitors and corrects rejected claims due to HIM coding. Works as a liaison with PFS and other internal departments to serve as a communicator/problem-solver for hindrances that prevent reimbursement. Based on new coding requirements, audit findings, RACs, MACs, etc. prioritizes and supports develops training/education protocols for UHS hospital coders in ICD-9-CM, CPT-4, APCs, Emergency Room Evaluation and Management Coding, Level II coding guidelines,...

Job Description Job Description Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25–35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology . The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission....

DISCOVER IES Integrative Emergency Services ("IES") LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit. POSITION SUMMARY Integrative Emergency Services, LLC ("IES") is seeking a Certified Medical Coding Specialist with emphasis on surgical services. Although a surgical related coding certification is preferred,...

Overview What you can expect: Find joy in serving others with IEHP. We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience. The Compliance Auditor II conducts comprehensive audits and reviews across the Plan, including assigned areas and Plan delegates, to ensure adherence to Federal, State, and contractual regulatory requirements. Identifies and assesses risks impacting overall compliance, drafts detailed audit findings and actionable recommendations, and evaluates operations, policies, and processes throughout the Plan. Conducts evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues. Issues corrective action plans and reviews for acceptance to ensure that all compliance issues are appropriately addressed. Performs validation audits to determine if actions have been taken to mitigate identified risks and conducts routine monitoring across...

Summary This position is located in the Health Information Management (HIM) section at the Fargo VA Health Care System. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. Responsibilities The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA)...

Remote Professional Fee Coding Auditor Remote Professional Fee Coding Auditor VISN 7 Health Information Management Services - Remote United States This Position Is Contingent Upon Contract Award Work Location Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 7 Health Information Management Services Remote within the United States Supporting VISN 7 medical facilities Fully remote coding and auditing services Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position. Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable system-access...

Remote Professional Fee Coding Auditor Remote Professional Fee Coding Auditor VISN 7 Health Information Management Services - Remote United States This Position Is Contingent Upon Contract Award Work Location Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 7 Health Information Management Services Remote within the United States Supporting VISN 7 medical facilities Fully remote coding and auditing services Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position. Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable system-access...

Remote Professional Fee Coding Auditor Remote Professional Fee Coding Auditor VISN 7 Health Information Management Services - Remote United States This Position Is Contingent Upon Contract Award Work Location Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 7 Health Information Management Services Remote within the United States Supporting VISN 7 medical facilities Fully remote coding and auditing services Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position. Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable system-access...

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Professional Fee Coding Auditor based in the United States. This fully remote role supports coding quality and compliance across medical facilities within a large regional healthcare network. You will independently audit professional-fee coding for documentation accuracy, regulatory compliance, and reimbursement impact. The position focuses on provider services, diagnoses, procedures, evaluation and management coding, modifiers, and professional components. You will identify discrepancies, document findings, assess financial and compliance risks, and recommend corrective actions. The role also includes preparing reports, participating in calibration activities, and delivering facility-specific coding education. You will collaborate with health information management leadership and facility stakeholders while maintaining strict confidentiality....

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Surgery Coding Auditor based in the United States. This fully remote role focuses on auditing surgical and procedural coding across multiple healthcare facilities. You will evaluate coding accuracy, documentation support, compliance, bundling, modifiers, and reimbursement implications. The position requires strong expertise in surgical coding and the ability to identify errors, risks, and opportunities for process improvement. You will document findings with authoritative support and contribute to detailed audit reports and corrective-action recommendations. The role also includes facility-specific coding education and participation in stakeholder discussions and exit conferences. You will work independently while collaborating with health information management leadership and facility personnel. The assignment combines technical coding...

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Inpatient/Outpatient Coding Auditor based in the United States. This fully remote role supports healthcare coding quality across multiple medical facilities within a large regional health network. You will independently audit inpatient and outpatient records for coding accuracy, documentation support, compliance, and reimbursement impact. The position combines detailed record review with reporting, quality improvement, and facility-specific education. You will evaluate complex coding across diagnoses, procedures, modifiers, DRGs, bundling rules, and reimbursement requirements. The role offers an opportunity to apply advanced coding expertise in a structured, regulated healthcare environment. You will collaborate with health information management leadership and facility stakeholders while maintaining high standards for accuracy and...

Coder IIOur client, a healthcare company, is looking for a Coder II for their Costa Mesa, CA location. Responsibilities The coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verify that all ICD-10-CM codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. In addition to the above, the coder meets ongoing productivity and quality standard of 95% accuracy rate or...

Duties of this position include, but are not limited to, the following:Position purposeThe Compliance Auditor will be responsible for researching and analyzing the medical records where there is a discrepancy in coding, validating the coding, and preparing reports that summarize audit findings and provide recommendations for corrective actions, if warranted.Responsibilities/Duties/Functions/Tasks:Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues.Examine claims for compliance with relevant billing and processing guidelines and identify opportunities for fraud and abuse prevention and control.Reports coding patterns identified within the audit process to the Manager and identifies corrective measures for compliance problems.Responsible for researching errors or missing documentation from medical records to provide accurate coding processes.Provides second-level review of billing performance to ensure compliance with...

Overview Reporting to the Director of Healthcare Compliance, the Senior Compliance Coding Auditor is responsible for conducting independent coding, billing, documentation, and regulatory compliance audits across ambulatory and specialty care practices. The position supports the organization's compliance program through risk-based auditing, monitoring, provider education, investigation of billing concerns, identification of revenue integrity risks, and development of corrective action plans. The Senior Compliance Coding Auditor serves as a subject matter expert for professional fee coding, documentation requirements, government and commercial payer regulations, and healthcare compliance standards. This role partners closely with physicians, advanced practice providers, practice leadership, revenue cycle, coding, clinical operations, and executive leadership to promote compliant billing and documentation practices. Responsibilities Essential Functions: Auditing and Monitoring...

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...

Job Description 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 policies....

Remote Inpatient/Outpatient Coding Auditor Remote Inpatient/Outpatient Coding Auditor VISN 7 Health Information Management Services - Remote United States This Position Is Contingent Upon Contract Award Work Location Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 7 Health Information Management Services Remote within the United States Supporting VISN 7 medical facilities Fully remote coding and auditing services Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position. Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable...

Remote Professional Fee Coding Auditor Remote Professional Fee Coding Auditor VISN 7 Health Information Management Services - Remote United States This Position Is Contingent Upon Contract Award Work Location Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 7 Health Information Management Services Remote within the United States Supporting VISN 7 medical facilities Fully remote coding and auditing services Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position. Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable system-access...

Professional Fee Coding AuditorAt 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 DUTIESAudit ResponsibilitiesPerforms 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...

Location: Miami, FL (On-site preferred; Hybrid/Remote may be considered) Employment Type: Part-Time (25-35 hours per week) About the Position We are seeking an experienced Senior Medical Coding Auditor (CPC) to join our growing multi-specialty medical practice specializing in Primary Care and Gynecology. The ideal candidate will be responsible for reviewing clinical documentation before claims are submitted to ensure accurate coding, appropriate E/M level selection, documentation compliance, and optimal reimbursement while maintaining full regulatory compliance. This position works closely with providers, clinical staff, and the billing department to improve documentation quality, reduce claim denials, maximize appropriate reimbursement, and ensure coding accuracy. Primary Responsibilities Review approximately 300 provider notes per week for coding accuracy and documentation compliance prior to claim submission. Validate appropriate Evaluation & Management (E/M) level...

Join a Team Where Your Expertise Impacts Lives: Medical Coding Specialist Camber Mental Health, a subsidiary of KVC Health Systems, is seeking a dedicated Medical Coding Specialist to serve as our resident subject matter expert. If you are a certified professional looking to apply your skills in a high-impact behavioral health setting, we invite you to join an organization that prioritizes authenticity, compassion, and innovation. At KVC and Camber, we believe the heart of our work is helping people. Our commitment to our staff is reflected in our Indeed Work Wellbeing score of 83, demonstrating our dedication to a supportive and fulfilling professional environment. The Role As the Medical Coding Specialist, you will ensure the integrity of patient records by accurately assigning diagnostic and procedural codes. Your work is vital to maintaining regulatory compliance and ensuring proper insurance reimbursement, directly supporting our ability to provide high-quality care...