- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …as provide guidance, training, and education to ensure high standards of coding compliance . The Coding Auditor must demonstrate excellent customer service and ... incredible work. What Will you Do? As a Coding Auditor at Pine Rest, you'll be part of tight-knit...coding regulations and best practices. + Collaborate with coding, billing , and compliance teams to develop and… more
- Baystate Health (Springfield, MA)
- …diversified duties in connection with reviews of medical record documentation for professional billing to ensure it meets the AMA and CMS (Medicare) guidelines for ... interacts with employees at all levels. The incumbent has an understanding of compliance audit concepts. This includes but is not limited to relaying confidential… 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
- MyFlorida (Tallahassee, FL)
- JUSTICE ADMINISTRATIVE COMMISSION- AUDITOR I - 21013472 Date: Aug 20, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... 859224 Agency: Justice Administrative Commission Working Title: JUSTICE ADMINISTRATIVE COMMISSION- AUDITOR I - 21013472 Pay Plan: Justice Admin Comm. Position… more
- MedKoder (Mandeville, LA)
- …work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty ... including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to… more
- Ochsner Health (New Orleans, LA)
- … billing regulations and medical necessity guidelines (which includes compliance with applicable laws and regulations), business risk, effective risk management ... This job assists with maintaining an effective auditing and compliance program. Independently completes assignments, manages projects, performs research, audits,… more
- Humana (Phoenix, AZ)
- …about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and ... validate the mitigation of compliance risk across the organization. This team ensures that...federal and/or state requirements related to Provider Clinic operations, billing , investigations, and processes. Coordinates site visits for regulators,… more
- Atlantic Health System (Morristown, NJ)
- …providers, and billing department + Provides clarification on coding and compliance policies Required: * CPC Certification * Minimum 6 months experience in ... for assisting with coding inquiries from providers, charge posters, billing staff, etc. Principal Accountabilities: Coordinates, schedules, performs the professional… more
- SSM Health (MO)
- …**Worker Type:** Regular **Job Highlights:** Exciting opportunity for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus. ... are found to be unsubstantiated through review of the medical record and/or billing information. Tracks assigned cases and enters data of audit related information… more
- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description We are seeking a highly skilled Nurse Auditor who can understand the intricacies of standard medical coding, including ... The successful candidate will be responsible for adjudicating claims, maintaining compliance with client contracts, and ensuring accuracy in payment criteria. This… more
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