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  • Perform audits to assess the quality of documentation, accuracy of charge code assignment and review financial billing statements.
  • Answer any physician and/or clinic questions and concerns regarding current ICD-10 and CPT guidelines.
  • Provide coding training and updates for coding staff, physicians and clinics as assigned.

ICD-10 CPT Auditing Billing Compliance

20 jobs similar to Coding Compliance Auditor - Physicians Practice

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US

  • Conduct audits comparing medical record documentation to reported codes.
  • Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
  • Provide feedback, education, training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision and coding principles.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. Their platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

US

  • Ensuring the accuracy, integrity, and quality of coding practices within the HIM department.
  • Conducting thorough reviews of clinical documentation, coding, and billing processes to ensure compliance.
  • Educating and training coding staff on best practices and updates in coding guidelines.

Cooper University Health Care is committed to providing extraordinary health care. They focus on clinical innovations and access to facilities, equipment, technologies and research protocols, and offer competitive rates, compensation programs, benefits, and career growth.

US

  • Organizes and prioritizes assigned work to ensure completion within the assigned time frame.
  • Reviews charts and medical records, assigning ICD and CPT code combinations to each data element.
  • Audits for documentation opportunities and queries clinical staff to fill in any gaps.

Riverside Health System's mission is to care for others as we would care for those we love. We extend that sense of caring to every patient, resident and customer, as well as to each member of our team, offering care at all stages of life, in hundreds of locations.

US

  • Perform coding audits and reviews on a variety of professional fee record types.
  • Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
  • Assist in the design and presentation of educational seminars to clients and staff

UASI is an award-winning company with over 40 years of experience, offering consulting services. We have enduring partnerships with our valued clients, stability, and long-term success of our dedicated team.

US

  • Performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record.
  • Trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function.
  • Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of their team, you'll have the opportunity to join their quest for better health care, no matter where you work within the Northwestern Medicine system.

US

  • Demonstrates knowledge of basic audit skills and adheres to Internal Audit Standards and UPH Internal Audit policies and methodologies.

UnityPoint Health is committed to their team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row. They champion a culture of belonging where everyone feels valued and respected, and believe in equipping you with support and development opportunities to deliver an exceptional employment experience.

US

  • Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types
  • Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans
  • Perform necessary research to provide to the client to support findings.

UASI is recognized as a Top Workplace. With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we’ve built and the long-term success of our dedicated team.

US 5w PTO

  • Abstract information from patient medical records to assign correct codes and charges to outpatient surgical records, and/or observation cases.
  • Assign correct CPT, ICD-10-CM; HCPCS or ICD-10-PCS and DRGs for facility and/or professional charges, which would involve complex procedure and diagnostic coding within highly specialized coding areas.
  • Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).

OHSU is Oregon's only public academic health center. As Portland's largest employer, they offer learning and advancement opportunities in a system of hospitals and clinics across Oregon and Southwest Washington.

US

  • Review documentation to assign appropriate CPT, HCPCS, and ICD-10 diagnosis codes
  • Resolve edits in WQs (charge review, claim edit, and follow up) and review denials for possible corrected claims or appeals
  • Work with clinic supervisors and/or providers to resolve coding issues and questions, following applicable payer rules and guidelines

CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

US

  • Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
  • Ensure compliance with legal, regulatory, and organizational standards.
  • Ensure claims are processed correctly and on time with efficient management of records.

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. As an affiliate of Dignity Health, they work hand-in-hand with physicians and providers throughout California to provide comprehensive health care services.

US

  • Examines medical records to determine diagnoses, procedures, and complications.
  • Accurately sequences diagnoses & procedures, maintaining 95% accuracy.
  • Assigns ICD-10 and CPT Codes and performs charge reconciliation.

Cooper University Health Care is committed to providing extraordinary health care. They are continuously discovering clinical innovations. Cooper offers career growth through professional development and is the employer of choice in South Jersey.

US

  • Assign and sequence all ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes for services rendered accurately and completely.
  • Maintain coding quality of 95% or higher while meeting established productivity requirements based on encounter type.
  • Identify trends in documentation deficiencies and communicates areas of improvement opportunities to leadership and/or providers.

Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact.

US

  • Train all new coders on department policies, procedures and correct coding principles
  • Analyze coder's workload and make recommendations to assigned supervisor to ensure all work is completed by the specified timeframes
  • Research and provide guidance to coders and other DHMF/CSH staff on coding-related questions or concerns

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. As an affiliate of Dignity Health, they work hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.

US

  • Responsible for coding procedures and entering charges to comply with regulations and internal policies.
  • Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present.
  • Participate in audits to evaluate if all selected codes are accurate and develop methodologies to improved coding issues.

Northside Hospital is an award-winning and state-of-the-art hospital that is continually growing. They are expanding the quality and reach of their care to patients and communities which creates more opportunity for healthcare professionals in Atlanta and beyond.

US

  • Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
  • Ensure compliance with legal, regulatory, and organizational standards with your expertise and training.
  • Review patient medical record information via population health tools to identify, assess, monitor and review network coding opportunities.

Dignity Health Management Services Organization (Dignity Health MSO) aims to build a system-wide integrated physician-centric, full-service management service organization structure. They provide management and business services, leveraging economies of scale and leading efforts in developing Medicaid population health care management pathways.

US

  • Accurate coding of professional services from medical record documentation.
  • Reviews, codes and assigns correct ICD-10-CM diagnosis codes.
  • Knowledge of insurance company, third-party and government reimbursement programs.

University Health (UH) is committed to being a leader in providing healthcare. UH is an equal opportunity employer committed to a culturally inclusive workplace that values and celebrates differences.

US

  • Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for medical diagnoses and procedures based on clinical documentation.
  • Ensure coding compliance with CMS guidelines, and state/federal regulations. Ability to write precise, professional, and well structured feedback to providers and team members.
  • Assist with claim reviews, denials, and coding-related audits to optimize revenue integrity.

Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Their mission is to improve the quality of life throughout Arizona by helping communities “Live Better, Live Longer” through personalized healthcare.

US

  • Performs the final reconciliation on clinic or provider visits.
  • Reviews, abstracts, and codes multiple or sub specialty services and complex or unusual cases, and assigns appropriate coding classifications.
  • Interacts with coding staff, business office, providers, hospital staff, clinic managers, and other clinical personnel on billing related issues.

University of Utah Health is a patient-focused organization that enhances the health and well-being of people through patient care, research, and education. They are a Level 1 Trauma Center and are nationally ranked and recognized for their academic research and quality standards.

US

  • Advanced knowledge of coding guidelines.
  • Responds to coding related questions.
  • Assists in reviewing and responding to denials.

Northeast Georgia Health System (NGHS) is a non-profit organization dedicated to improving community health through various initiatives. With a team of caregivers serving over 1 million people across the region, NGHS consists of five hospitals and numerous outpatient facilities.

US

  • Review clinical documentation and assign accurate ICD-10-CM, HCPCS, and CPT codes to encounters
  • Ensure compliance with CMS, payer, and risk adjustment coding guidelines
  • Collaborate with clinicians and billing staff to clarify documentation or coding discrepancies

Main Street Health is the nation's largest provider of value-based care exclusively serving rural America. They partner with rural primary care doctors and reinforce the importance of trust and relationship-driven care in rural communities.