193 senior compliance coding auditor jobs found

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. The Senior Compliance Coding Auditor will have dotted line reporting to the Chief Compliance & Risk Officer. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding....

A healthcare organization is seeking a Senior Compliance Coding Auditor to perform coding audits and ensure adherence to regulatory standards. The ideal candidate will conduct chart reviews, identify discrepancies, and educate medical staff on coding practices. Preferred qualifications include a CPC or CCS certification, 4 years of experience, and knowledge of the Epic EHR system. This full-time role offers a competitive salary reflecting industry standards for healthcare compliance professionals. #J-18808-Ljbffr

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report findings and...

Overview This position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD‐10 codes on an annual basis. Responsibilities Essential Duties: • Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical and/or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer/title/grant coding requirements.• Identify coding discrepancies and formulate suggestions for improvement.• Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas.• Work with the Office of the CMO and provider leadership to identify and assist providers with coding.• Report findings and recommendations to...

OverviewThis position is responsible for conducting coding audits, communicating results and recommendations to providers, management, and executive administration, and providing training and education to providers and ancillary staff.This position will support the implementation of changes to the CPT, CDT, HCPCS and ICD-10 codes on an annual basis.ResponsibilitiesEssential Duties :Conduct prospective and retrospective chart reviews (i.e.baseline, routine periodic, monitoring, and focused) comparing medical and / or dental record notes to reported CDT, CPT, HCPCS, and ICD codes with consideration of applicable FQHC and payer / title / grant coding requirements.Identify coding discrepancies and formulate suggestions for improvement.Communicate audit results / findings to providers and / or ancillary staff and share improvement ideas.Work with the Office of the CMO and provider leadership to identify and assist providers with coding.Report findings and recommendations to Compliance...

Overview This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis. Responsibilities Essential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with medical staff department to identify and assist providers with coding. Report...

A leading health insurance provider in Mississippi is seeking a Senior Clinical Compliance Auditor. This role involves reviewing clinical data, coordinating and validating billing practices for healthcare providers, and working closely with various teams. Required qualifications include a Bachelor's degree in Nursing and at least three years of relevant experience. The ideal candidate will possess strong communication, organizational, and analytical skills. Join us to promote health and wellness throughout Mississippi. #J-18808-Ljbffr

A healthcare organization in Wisconsin is seeking a coding auditor to conduct billing and coding audits, provide training, and ensure compliance with regulations. The ideal candidate has extensive experience in procedural and diagnostic coding, with relevant certifications. Strong attention to detail and communication skills are essential. This position offers a chance to work within a collaborative environment focused on compliance and accurate reporting. #J-18808-Ljbffr

A healthcare provider in San Diego seeks a Compliance Coding Auditor to oversee compliance audits related to coding and billing practices. The role involves ensuring adherence to regulations, conducting audits, and providing reports to improve compliance within the organization. A Bachelor's degree and relevant experience in coding are required. Certification in clinical documentation improvement is preferred. The position also demands excellent communication skills and the ability to function in a fast-paced environment. #J-18808-Ljbffr

A leading healthcare organization in St. Louis is seeking an experienced auditor to ensure compliance and accuracy in coding practices. This role includes responsibilities such as analyzing inquiries on compliance, training specialty providers, and conducting thorough reviews of documentation. Candidates should have 5-10 years of experience, a high school diploma or GED, and CCS/CPC certification. This position offers a remote opportunity and comprehensive benefits from day one, including medical, dental, and retirement contributions. #J-18808-Ljbffr

Job Description: This position is 100% on-site in Flowood, Mississippi 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 data analysts, compliance auditors, and the Medical Director to identify aberrant trends in patient care, utilization, and billing practices. The incumbent works with a multidisciplinary team to determine appropriate interventions to address and resolve identified...

Description Summary: The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with...

Description Summary: The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with...

42910BR Extended Job Title: Medical Coding Auditor Org Level 1: Texas Tech Unv Hlth Sci Ctr El Paso Position Description: Responsible for auditing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to provide education on medical coding and documentation based on audit findings and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding accuracy and assure regulatory requirements are met. Requisition ID: 42910BR Travel Required: Up to 25% Major/Essential Functions: Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers. Researching...

Job Title: Surgical Coding Auditor & Senior Revenue Integrity Educator (Contract) Overview Seeking an experienced Senior Surgical Coding Auditor and Rev Integrity Educator to support our clients growing surgical revenue integrity team. This is a 12\u2011month, full-time contract role focused primarily on independent surgical coding and documentation audits, along with targeted provider education and consulting. The ideal candidate is a seasoned auditor who thrives without handholding, brings strong surgical coding expertise, and can quickly adapt to new specialties and audit scenarios. Key Responsibilities Conduct comprehensive coding and documentation audits for surgical services across inpatient and/or outpatient settings. Independently manage audit workload with minimal supervision Identify documentation deficiencies, coding errors, and revenue risk areas; provide clear and actionable feedback. Deliver provider education , one-on-one or in group...

Job Title: Surgical Coding Auditor & Senior Revenue Integrity Educator (Contract) Overview Seeking an experienced Senior Surgical Coding Auditor and Rev Integrity Educator to support our clients growing surgical revenue integrity team. This is a 12month, full-time contract role focused primarily on independent surgical coding and documentation audits, along with targeted provider education and consulting. The ideal candidate is a seasoned auditor who thrives without handholding, brings strong surgical coding expertise, and can quickly adapt to new specialties and audit scenarios. Key Responsibilities Conduct comprehensive coding and documentation audits for surgical services across inpatient and/or outpatient settings. Independently manage audit workload with minimal supervision Identify documentation deficiencies, coding errors, and revenue risk areas; provide clear and actionable feedback. Deliver provider education , one-on-one or in group...

Overview Hi, we\'re Oscar. We\'re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If...

General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday-Friday, 8:00am-5:00pm PST Posted Date 12/10/2025 Salary Range : $86400 - 184800 Annually Employment Type 2 - Staff: Career Duration Indefinite Job # 27889 Primary Duties and Responsibilities Press space or enter keys to toggle section visibility Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan,...

Data Quality Senior Medical Coder - Remote Full-time Shift: Day Shift Status: Full Time More Than Just Care,It’sCommunity Imagine doing meaningful work in a place where peoplevacation. That’slife 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 alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just beMunson 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 onlinedevelopment,and access to ourcareer hubto help...

Compliance Auditor, MAPD Support compliance excellence at UCLA Health by joining our team as a compliance auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct risk adjustment data validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the compliance manager, MAPD audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, triennial review, pre-delegation...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely.   Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

Senior Clinical Compliance Auditor page is loaded## Senior Clinical Compliance Auditorlocations: Flowood, MStime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100294# Healthy Careers Start HereAt 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...