87 senior clinical compliance auditor jobs found

Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. Job Summary The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers. The Senior Clinical Compliance Auditor collaborates with...

A leading healthcare organization in Fort Lauderdale is seeking a Clinical Compliance Specialist. This pivotal role involves ensuring alignment of clinical operations with healthcare regulations, focusing on audits and documentation quality. Candidates should have at least 5 years of experience in a healthcare setting, with a preference for a Bachelor's degree in Healthcare Administration. This position offers opportunities for professional growth and requires strong analytical skills and a clinical perspective. #J-18808-Ljbffr

About Us The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe. Exciting Opportunity at MSK Senior Healthcare Coding & Billing Compliance Specialist (Auditor) At Memorial Sloan Kettering (MSK), our Compliance team ensures the highest standards of integrity and accountability across our institution. As a Senior Healthcare Coding & Billing Compliance Specialist (Auditor), you'll help...

Req Number 174853 Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

About Us: The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe. Exciting Opportunity at MSK: Senior Healthcare Coding & Billing Compliance Specialist (Auditor) At Memorial Sloan Kettering (MSK), our Compliance team ensures the highest standards of integrity and accountability across our institution. As a Senior Healthcare Coding & Billing Compliance Specialist (Auditor) , you’ll help...

Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in healthcare compliance...

Job Description Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise Needed. This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Are you a seasoned compliance professional with a passion for anesthesia and healthcare auditing? Do you thrive in fast-paced environments where your expertise can make a real impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge in safeguarding healthcare integrity and regulatory excellence! Position Summary: As a Lead Compliance Auditor, you will leverage your extensive anesthesia auditing experience to oversee comprehensive compliance reviews, develop training programs, and collaborate with senior leadership to enhance our compliance framework. Your expertise will ensure the organization remains at the forefront of regulatory adherence, risk mitigation, and quality improvement. Ready to make a difference in...

Join to apply for the HIM - INPATIENT HOSPITAL CODER (Exp.) role at LifeBridge Health Join to apply for the HIM - INPATIENT HOSPITAL CODER (Exp.) role at LifeBridge Health REMOTE WORK OPPORTUNITY Competitive Benefits REQUIRED CERTIFICATIONS - CCS or CCA with 5+ years’ experience or RHIT or RHIA Summary REMOTE WORK OPPORTUNITY Acceptable remote locations: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia Competitive Benefits REQUIRED CERTIFICATIONS - CCS or CCA with 5+ years’ experience or RHIT or RHIA JOB SUMMARY: Following established conventions and guidelines, codes and abstracts the medical records of inpatients. Groups codes to determine diagnosis related groupings (DRGs-CMS and/or APR). May be asked to code day surgery, emergency and outpatient records. Meets departmental accuracy and production standards. Essential Functions Codes Reviews medical records to determine the physicians diagnosis/procedures for the patient and assigns...

We are seeking a Sr. Compliance Auditor Trainer who will provide on-going training and support to physicians, non-physician providers, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation and billing requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service, and the Johns Hopkins Health System Compliance Office. The documentation audits are conducted as part of the School of Medicine's Quality Assurance Compliance Program. Prepares reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. Summary results are presented to the Clinical Practice Association's Board of Governors, the University's Trustee Committee for Audits and Insurance and other appropriate...

Senior Coding Compliance Auditor and Educator Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Senior Coding Compliance Auditor and Educator 3 days ago Be among the first 25 applicants Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Get AI-powered advice on this job and more exclusive features. General Job Summary : The Senior Coding Compliance Auditor and Educator will be responsible for auditing outpatient professional services documentation ensuring compliance with coding and billing guidelines, identifying areas for improvement, and providing training to clinicians and coders to support accuracy, compliance, and adherence to industry standards. This role involves both auditing medical records and educating coders, providers, and staff on professional coding guidelines and best practices. (this is a full-time position that will support our Compliance team, Monday to...

Professional Fee Coder/Auditor Join to apply for the Professional Fee Coder/Auditor role at Strive Health Services LLC Overview At Strive Health, we’re driven by a purpose: transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care, we significantly improve outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization. Our high‑touch care model integrates with local providers and uses predictive data to identify and support at‑risk patients along their entire care journey. We embrace diversity, celebrate successes, and support each other, making Strive the destination for top talent in healthcare. Join us in making a real difference. Benefits & Perks Hybrid‑Remote Flexibility – Work from home while fulfilling in‑person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer‑paid and...

Join to apply for the Professional Coding Compliance Auditor role at Emory Healthcare Join to apply for the Professional Coding Compliance Auditor role at Emory Healthcare Get AI-powered advice on this job and more exclusive features. Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare w e fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare w e fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career And Be What You Want To Be. We Provide Comprehensive health benefits that start day 1 Student Loan Repayment Assistance &...

Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic’s policies and procedures and accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform audits outlined in the work plan. Requires ability to present detailed analysis of audits in both written and spoken form. Relies on professional judgement to ensure Internal Audit and Compliance standards are used to assess compliance with CPT, ICD-9/10, HCPCS, Payor, CMS guidelines and TGC policies Experience: - Working knowledge of medical terminology, anatomy and physiology, and coding guidelines including CPT, ICD- 9 /10-CM, and HCPCS coding systems and guidelines, payer guidelines and requirements. - Minimum 1-year experience in Physician coding and billing and/or compliance field required 5 year of clinical experience and/or knowledge and understanding of Medical Records auditing...

By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda’s Privacy Notice and Terms of Use. I further attest that all information I submit in my employment application is true to the best of my knowledge. Job Description OBJECTIVES Provides oversight from a clinical research and pharmacovigilance perspective of regulated post‑authorization activities in the commercial business units and affiliates. Contributes to and implements the engagement strategy among R&D, Business Units and affiliates and Quality to ensure a global framework and robust quality systems are in place for the transition of R&D pipeline to the commercial space. Drives a fit‑for‑use global Quality framework that elevates the capabilities in the business units and the affiliate and enables them to deliver their clinical research and pharmacovigilance‑related...

Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Provides consulting services to the organization's management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician office staff. Serves as a resource to coders, CDI staff, Quality and Case...