Staff coding compliance auditor jobs

Full Time

HIM Professional Billing Coding Manager (Hybrid)

El Camino Health Hybrid (Mountain View, CA)

Lead Coding. Drive Revenue Integrity. Shape Provider Performance. El Camino Health is seeking a highly experienced HIM Professional Billing Coding Manager to lead coding operations across its medical network. This is a critical leadership role directly tied to revenue cycle performance, compliance, and provider documentation excellence. If you bring deep expertise in professional billing (PB) coding, auditing, and provider education , this is your opportunity to make a meaningful impact within a respected, nonprofit health system. About El Camino Health El Camino Health is an integrated, nonprofit health system known for delivering high-quality, patient-centered care across its communities. With a strong commitment to innovation, compliance, and clinical excellence, the organization plays a vital role in driving healthcare outcomes and access across the region. This position is onsite in Mountain View, CA 2 days a week, with 3 days available for remote work....

RU

Full Time

Healthcare Coding Compliance Auditor

Riverside University Health System Medical Center Hybrid (Riverside, CA)

Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care hospital...

UO

Lead Oncology/Radiation Coding Auditor/Educator

US Oncology Inc. Saint Paul, MN

Overview At Minnesota Oncology, we believe that our people are our greatest asset, and we are committed to fostering a diverse and inclusive workplace where everyone can thrive. We are constantly on the lookout for talented individuals who are passionate, driven, and eager to make a difference. Come join this dynamic team who is passionate about providing exceptional care to our patients. Why Work for Us? We offer a competitive benefits package that includes - Medical Dental Vision Free Life Insurance Generous Paid Time Off (PTO) Plan Free Short-term and Long-term Disability Coverage 401k plan with company contribution Wellness program that rewards your healthy lifestyle Tuition Reimbursement Employee Assistance Program and Discount Program to some of your favorite retailers Free Parking Career Growth and Development Supportive Team and Resources Responsibilities SCOPE: Under minimal supervision performs comprehensive audits for all assigned medical and radiation...

UT

Inpatient Medical Coder

US Tech Solutions Columbia, SC

Medical Review Auditor Duration: 3+ Months (Possible contract to hire) Job Description: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates. Manages records retrieval, release, HIPAA compliance, and all aspects of document management. Serves...

CS

Sr Coding Compliance Auditor

Common Spirit Health Chattanooga, TN

Sr Coding Compliance Auditor Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an emphasis on documentation, coding improvement, and revenue capture. Provides education to clinicians, clinic staff, and others as needed via face-to-face meetings, classroom settings, webinars, and online modules. Develops, maintains and presents coding and compliance educational materials to staff and clinicians. Collaborates with the coding team to support the needs of the organization. The...

YC

Compliance Auditor

Yale Cancer Center New Haven, CT

Overview Coordinate and conduct medical billing audits for the Yale Medicine Administration. Evaluate medical billing, coding and documentation for 18 clinical departments under the direction of the Compliance Officer. Provide training and feedback to physicians and departmental personnel who have responsibilities with billing activities. This opportunity is currently remote (work from home, in or outside CT) for a position located in CT. CPC required. If the candidate does not currently hold a CPC certification, it is expected to be obtained within 6 months to 1 year after hire. Required Skills and Abilities Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices. Ability to interpret operative and procedural reports. Well-developed oral and written communication skills. Strong attention to detail with the ability to analyze data. Proficient in Microsoft Word, Excel, and Access. Preferred Skills and Abilities CPC credentials preferred. Computer skills...

NH

Outpatient Coding Auditor

Nuvance Health Danbury, CT

Position at Nuvance Health Must reside in the following states: AZ, CT, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MS, NC, NH, NJ, NY, OH, PA, SC, TN, TX, and VA Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State's largest private employer with over 104,000 employees including members of Northwell Health Physician Partners who are working to change health care for the better. Summary Purpose: Provides clinician practice coding, billing, and documentation auditing for professional coding at Nuvance Health. Conducts routine quality assurance (QA) audits on Professional Coding team and...

UH

Coding Compliance Auditor (2223)

US Heart and Vascular Franklin, TN

Coding Compliance Auditor Fully Remote Overview Position Type Full Time Education Level High School Diploma/GED Category Other Positions Description US Heart and Vascular is in need of a Remote Coding Compliance Auditor to join our team. The Coding Compliance Auditor performs internal medical record audits and prepares compliance auditing reports, subsequent educational materials and training as directed by the Compliance and Privacy department. Audits include regular compliance medical record audits or focused review projects for ongoing review of coding and documentation for cardiovascular specialties to support compliance with coding and documentation rules and regulations. Responsibilities: Performs coding audits reviewing for compliance and accuracy with CPT, ICD-10, HCPCS and corporate coding policy and follows up for timely completion within designated time period. Maintains excellent documentation of all reviews, methodologies employed, results, corrective...

AA

Professional Coding Auditor and Educator

Anne Arundel Dermatology Owings Mills, MD

divh2Coding Auditor And Educator/h2pAt Anne Arundel Dermatology we give exceptional care - to our patients and to eachother./ppPatient First | Caring | Accountability | Trust | One Team | Growth/ppThe 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 patients 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, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience...

IG

REMOTE - Coding Auditor

Insight Global Linthicum Heights, MD

divh2Auditor Position/h2pInsight Global is seeking an auditor to accurately audit hospital inpatient, ambulatory surgery, observation, and outpatient encounters to ensure appropriate reimbursement, research accuracy, and compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems. Responsibilities include, but are not limited to:/pulliAudit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation encounters/liliAudit complex inpatient cases including trauma, rehab, neurology, and critical care/liliEnsure accurate APR-DRG, SOI/ROM, and POA assignment/liliServe as a clinical coding subject matter expert and resource to coding specialists/liliProvide education, training, and guidance to coding staff/liliMonitor coding quality accuracy and productivity rates/liliConduct specialized and focused audits as needed/liliCollaborate with CDI, medical staff, and clinical documentation specialists/liliAssist with...

RM

HCC Risk Adjustment Coder I

Regal Medical Group Los Angeles, CA

Hcc Risk Adjustment Auditor/Coder We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use...

HH

Coder III : Medical Coding

Hoag Health System Costa Mesa, CA

Job Description Primary Duties And Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT 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. Verifies that all ICD-10-CM and CPT 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. Medical Coding - Hoag Hospital Resolves billing related errors and assists with workflow changes and process improvement projects....

VS

Clinical Coding Auditor & Trainer

Veracity Solutions New York, NY

Clinical Coding Auditor & Trainer Remote (U.S.) Must be willing to travel to New York twice annually Position Type: Full Time The Clinical Coding Auditor & Trainer is responsible for conducting clinical documentation and coding audits to ensure compliance with federal regulations, payer requirements, and company policies. This position focuses on DRG validation, inpatient medical record auditing, and education/training for clinical and coding teams. The role is primarily remote, with occasional travel to New York twice a year for onsite meetings or training sessions. The ideal candidate will possess strong analytical and clinical expertise, proficiency in medical coding standards, and exceptional written communication skills to ensure audit accuracy and compliance across departments. Key Responsibilities: Conduct DRG validation and inpatient coding audits to ensure medical record accuracy and compliance. Provide training and education to clinical, coding, and quality...

LH

Medical Coding Auditor

LMH Health Lawrence, KS

Join LMH Health You can't define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full with joy, purpose and lifelong health it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you're looking for at LMH Health. You'll find everything you're looking for at LMH Health: Join a team that cares about the community Tuition reimbursement to support continuing education Professional development and recognition Excellent benefits Job Description The Medical Coding Auditor is responsible for conducting prospective and retrospective compliance reviews of documentation supporting codes reported by providers or facility coding to ensure accuracy in billing, maximize charge capture, and comply with Federal, State,...

KM

Coding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Keck Medicine of USC Los Angeles, CA

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

di

Facility Inpatient Coder | , |

divvyDOSE United States

Regulatory Compliance Auditor Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Position in this function is responsible for regulatory compliance audits, including but not limited to regulatory agencies, quality metrics, and coding compliance. The Auditor will monitor changes to laws and regulations to ensure compliance with state and federal laws, regulations and mandates. Establish and implement standard policies, procedures, and best practice across...

Pe

Medical Coder Auditor/Educator

Pediatrix United States

Overview We have a Medical Coding Auditor/Educator Career opportunity for an experienced professional to join our team at Pediatrix Medical Group. We are a national organization, and one of the nation's largest providers of prenatal, neonatal and pediatric services. Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere. We are confident that you'll love being a part of the Pediatrix team. Responsibilities The Medical Coding Auditor/Educator will evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. They will be responsibile for accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education; coding education to...

FH

Internal Auditor Coder - Full-time with Benefits

Frederick Health Frederick, MD

Internal Auditor Coder - Full-time with Benefits Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior. Audits, codes and abstracts inpatient and outpatient medical records of all types and, following a rigorous review of the clinical documentation, abstracts and assigns appropriate ICD-10-CM/PCS code sets and assigns the correct APR-DRG into the hospital information system. May also participate in other Special Projects as assigned by the Coding Manager. Example of Essential Functions: Audits both inpatient and outpatient records of all patient types for completeness of coding and determination of the clinical significance of codes assigned. Ability in Report Writing and use of Excel Spreadsheets. Provide education and feedback to staff....

RC

Healthcare Coding Compliance Auditor - RUHS

Riverside County, CA Riverside, CA

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience...

SS

Coding and Compliance Auditor

South Shore Health Boston, MA

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare reports to deliver provider education...

SS

Coding and Compliance Auditor

South Shore Health Boston, MA

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare reports to deliver provider education...

SS

Coding and Compliance Auditor

South Shore Health Boston, MA

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare reports to deliver provider education...

SS

Coding and Compliance Auditor

South Shore Health Scituate, MA

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare reports to deliver provider education...

SS

Coding and Compliance Auditor

South Shore Health Boston, MA

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection. Analyzes data to identify deficiencies, prepare reports to deliver provider education...

657 staff coding compliance auditor jobs found