Top 1152 Healthcare auditor Jobs

Coder Auditor/Senior CDI Specialist
HAMASPIK CHOICE INC —Spring Valley, NY
- $83,000 - $90,000 a year
- Full-time
- Writing skills
- Mid-level
Quick Apply
Coder Auditor/Senior CDI Specialist
HAMASPIK CHOICE INC —Brooklyn, NY
- $83,000 - $90,000 a year
- Full-time
- Writing skills
- Mid-level
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Patient Safety DRG Clinical Validation Auditor
Elevance Health —Indianapolis, IN
- $86,560 - $129,840 a year
- Full-time
- RN License
- 5 years
- Continuous improvement
- Employee stock purchase plan
- Paid holidays
Claims Manager, Audit & Complaints
MetroPlusHealth —New York, NY
- $100,000 - $120,000 a year
- Hybrid work
- 5 years
- Research
- Master's degree
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20h
Patient Safety DRG Clinical Validation Auditor
Elevance Health —Indianapolis, IN
- $86,560 - $129,840 a year
- Full-time
- RN License
- 5 years
- Continuous improvement
- Employee stock purchase plan
- Paid holidays
Claims Auditor
RiteChoice Rx —Remote
- Full-time
- Remote
- Mid-level
- Continuous improvement
- Travel
- Health insurance
- Dental insurance
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Healthcare Auditor II
Health Services Advisory Group, Inc. —Remote
- $80,000 - $90,000 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Outlook
- Writing skills
- Paid holidays
- Health insurance
Audit Reviewer (RN -Med/Surg)
Knowtion Health —Remote
- Full-time
- Remote
- Mid-level
- 3 years
- Medical-Surgical
- Paid holidays
- Disability insurance
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Clinical Auditor I-Nurse
WellSense Health Plan —Remote
- $64,000 - $93,000 a year
- Full-time
- Nursing
- RN License
- Bachelor's degree
- Health insurance
- Dental insurance
Facility Outpatient Auditor
Managed Resources, Inc (MRI) —Remote
- $30 - $35 an hour
- Full-time
- Remote
- Microsoft Word
- Research
- Mid-level
- Paid holidays
- Health insurance
10d
Patient Safety DRG Coding Auditor Principal
Elevance Health —Indianapolis, IN
- $116,128 - $210,864 a year
- Full-time
- Bachelor of Science
- Bachelor's degree
- Continuous improvement
- Employee stock purchase plan
- Paid holidays
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
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Auditor, Compliance (Remote in FL)
Molina Healthcare —Florida
- $54,922 - $107,099 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- 2 years
- Health insurance
Claims Auditor, Managed Care (remote)
Cedars-Sinai —Los Angeles, CA
- $27.18 - $42.13 an hour
- 8 hour shift
- Remote
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health insurance
- Dental insurance
Facility Auditor
Managed Resources, Inc (MRI) —Remote
- $30 - $35 an hour
- Full-time
- Remote
- Microsoft Word
- 5 years
- Research
- Paid holidays
- Health insurance
Inpatient Medical Coding Auditor
Humana —Remote
- $71,100 - $97,800 a year
- 8 hour shift
- Remote
- Microsoft Excel
- Mid-level
- Travel
- Paid parental leave
- Paid holidays
Senior Claims Auditor - DRG
Cohere Health —Remote
- $74,000 - $90,000 a year
- Remote
- Nursing
- 6 years
- HIPAA
- Paid parental leave
- Health savings account
Quick Apply
Professional Fee Coding Auditor
Managed Resources, Inc (MRI) —Remote
- $28 - $32 an hour
- Full-time
- Remote
- Microsoft Word
- 5 years
- HIPAA
- Paid holidays
- Health insurance
Clinical Documentation Integrity Auditor
Professional Credit Service —Remote
- $45 - $58 an hour
- Full-time
- Remote
- Nursing
- Writing skills
- 3 years
- Health insurance
- Dental insurance
Quick Apply
10d
Senior Auditor Quality - OPSP
Cotiviti —Remote
- $47 - $56 an hour
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- Computer literacy
- Paid holidays
- Disability insurance

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Coder Auditor/Senior CDI Specialist

HAMASPIK CHOICE INC -
Spring Valley, NY

Quick Apply

Job Details

Full-time
$83,000 - $90,000 a year

Qualifications

Collaborate with healthcare professionals
Medicare
Managed care
Managed care organization experience
Policy & process development
Clinical documentation
Resource utilization in healthcare
Clinical documentation improvement
Certified Risk Coder (CRC)
Clinical documentation standards
Medical record review for billing accuracy

Full Job Description

We are seeking a detail-oriented and experienced Coder Auditor to join our dynamic team. The ideal candidate will be responsible for ensuring the accuracy and completeness of clinical data used to support risk adjustment coding for our Medicare plan. You will work closely with healthcare providers and clinical teams to identify and mitigate documentation gaps, ultimately supporting our mission to provide exceptional care to our members.

Responsibilities:

Audit and QC the coding team’s output for accuracy and compliance with HCC/ICD-10-CM guidelines
Review disposition decisions
Speak directly with providers — writing and following up on provider queries for insufficient or ambiguous documentation
Educate providers on documentation practices that support accurate risk adjustment coding
Serve as the escalation point for complex charts and coding questions from the coding team
Track error patterns and trends in coding quality and report on them
Be able to work independently as a senior-level resource
Be comfortable owning second-level review
Strong knowledge of HCC hierarchy, RAF methodology, and CMS risk adjustment guidelines required

Specific Knowledge, Skills, and Abilities:

Ability to read and interpret documents, identify areas of coding gaps. Ability to speak effectively with physicians and employees of the agency.

Ability to identify areas of over or under utilization and work with team and physician groups to develop processes to avoid

Ability to work with team on development of processes for right-coding, appropriate utilization, and closing gaps in care

Required Education, Experience, and Licenses:

CRC certification required
Managed Care/Medicare Advantage experience required, dual-eligible or FIDE-SNP experience a plus
At least 3 years’ satisfactory experience in Managed Care, desired.

Quick Apply

Refine Your Search

healthcare auditor jobs

Coder Auditor/Senior CDI Specialist

Coder Auditor/Senior CDI Specialist

Patient Safety DRG Clinical Validation Auditor

Claims Manager, Audit & Complaints

Patient Safety DRG Clinical Validation Auditor

Claims Auditor

Healthcare Auditor II

Audit Reviewer (RN -Med/Surg)

Clinical Auditor I-Nurse

Facility Outpatient Auditor

Patient Safety DRG Coding Auditor Principal

Call Center Quality Assurance Auditor

Auditor, Compliance (Remote in FL)

Claims Auditor, Managed Care (remote)

Facility Auditor

Inpatient Medical Coding Auditor

Senior Claims Auditor - DRG

Professional Fee Coding Auditor

Clinical Documentation Integrity Auditor

Senior Auditor Quality - OPSP

I want to receive the latest job alert for healthcare auditor

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