- Fairview Health Services (St. Paul, MN)
- **Job Overview** **Fairview is looking for a Senior Corporate Compliance Auditor to join our Corporate Compliance department.** **Bring Your Possibilities to ... scenes, or supporting those who do, your work matters. The Senior Corporate Compliance Auditor is an independent, self-directed professional who possesses a… more
- Elara Caring (Dallas, TX)
- …at the Right Time, in the Right Place. **Job Description:** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, Hospice, ... Care Services (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and...billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited… more
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Auditor III Finance Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position ... required to achieve that purpose. Job Summary The Financial Compliance Auditor III Finance is a hybrid...(DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and… more
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for...for a variety of complex areas of the Medi-Cal, Medicare , Covered California, and PASC-SEIU benefit and process. This… more
- MVP Health Care (Schenectady, NY)
- Compliance Auditor Headquarters Office, 625 State Street, Schenectady, New York, United States of America Req #2662 Friday, June 20, 2025 At MVP Health Care, ... innovative thinking and continuous improvement. To achieve this, we're looking for a ** Compliance Auditor ** to join #TeamMVP. This is the opportunity for you… more
- Mohawk Valley Health System (Utica, NY)
- …year in a coding audit or educator role. + In-depth knowledge of compliance standards, including HIPAA, HITECH, and Medicare /Medicaid regulations. + Strong ... Supervisor Coding Auditor & Educator - Full Time - Days...and Education is responsible for overseeing medical coding accuracy, compliance , and education initiatives within the Medical Group. This… more
- Catholic Health (Kenmore, NY)
- …JOB SUMMARY: The Catholic Health (CH) Health Information Management (HIM) Educator/ Auditor will work cooperatively with CH coding associates, physicians, Inpatient ... Education Manager and Documentation Specialists, Quality and Patient Safety, Corporate Compliance , and Ancillary departments to ensure coding across CH acute care… more
- MedKoder (Mandeville, LA)
- …services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer ... remote position that offers a flexible schedule. Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …for Medicare and Medicaid Services (CMS) rules, regulations and compliance guidance required. + Excellent analytic and problem-solving skills to process auditing ... for clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours… more
- LA Care Health Plan (Los Angeles, CA)
- Senior Health Plan Auditor Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... achieve that purpose. Job Summary The Senior Health Plan Auditor is a hybrid role and is responsible all...action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These audits… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, and… more
- Humana (Santa Fe, NM)
- …a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and assigns ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor I Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: June 30, 2025 Apply with Linkedin Apply Department of Health ... to its staff. ABOUT THE POSITION: As a Staff Auditor I you will: + Perform professional audit work...funds through contracts with DHHS. + Complete financial and/or compliance audits for conformance to established laws, rules, regulations… more
- AdventHealth (Tampa, FL)
- …Primary Stroke Center. **The ro** **le you'll contribute:** The Coding Quality Auditor , under the general supervision of the Outpatient Coding Manager, is ... for the internal coding audit and clinical quality reviews. The Coding Quality Auditor will work in conjunction with the Outpatient Operations Manager to ensure the… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- Summary The Health Information Section (HIMS) Coding Auditor is responsible for coding and provider audits. Overseeing the appropriate coding assignment of ICD-10 ... any coding assigned. Responsibilities Duties of the Medical Records Technician (Coder) Auditor include but are not limited to: Performs weekly or monthly audits… more
- Trinity Health (Boise, ID)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Coding Auditor & Educator performs medical record audits including analysis of medical ... and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge… more
- Elevance Health (Atlanta, GA)
- **Clinical Provider Auditor II** **Virtual** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... eliminate and prevent unnecessary medical-expense spending. The **CLINICAL PROVIDER AUDITOR II** is responsible for identifying issues and/or entities that may… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor . You will review claims (paid, pending, and denied)...services, contract interpretation, Division of Financial Responsibility (DOFR), and application/ compliance with policies and procedures. You will: + Research… more
- Atlantic Health System (Morristown, NJ)
- …assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... + Audit charts for accurate and correct coding and compliance within documentation guidelines and AHS policies + Prepares...and billing department + Provides clarification on coding and compliance policies + CPC Certification + Minimum 6 months… more
- Highmark Health (Oklahoma City, OK)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
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