Coding Compliance Auditor

2 weeks ago


Washington, United States Medstar Full time

Position Overview
MedStar Family Choice is in search of a skilled Coding Compliance Auditor to enhance our DC Medicaid Plan team. The ideal candidate must hold a certification in Medical Coding and will be responsible for conducting audits and investigations to ensure adherence to both District and federal regulations related to the Medicaid Program Integrity.

Key Responsibilities
- Execute audits of providers to uncover and rectify improper billing practices.
- Analyze existing payment policies and propose enhancements to bolster program integrity.
- Manage responses to external inquiries, investigations, and data requests from government entities.
- Prepare comprehensive audit reports and communicate findings to management, initiating corrective action plans as necessary.
- Conduct monthly checks of exclusion databases and report any findings.
- Maintain confidentiality of sensitive information throughout the auditing process.

Qualifications
- High School Diploma or GED is mandatory; a Bachelor's degree is preferred.
- A minimum of one coding credential is required: Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC).
- At least four years of relevant experience is essential, with prior auditing experience in a healthcare or insurance setting being highly desirable.
- Proficient knowledge of healthcare billing regulations and coding guidelines is necessary.

Skills and Competencies
- Exceptional organizational skills with the ability to manage multiple tasks efficiently.
- Strong verbal and written communication abilities.
- Proficiency in MS Office applications is required.
- Ability to work independently with minimal supervision.

This position offers a competitive salary range based on experience and qualifications.



  • Washington, United States COMPLIANCE WEEK Full time

    Location: Remote Position Title: Principal Compliance Auditor Role Overview Elevate your career as a Principal Compliance Auditor within the Compliance division at Compliance Week. Our compliance team drives the organization’s Enterprise Risk Management initiatives, utilizing the Institute of Internal Auditors' Three Lines model. We ensure that our...


  • Washington, United States Medstar Full time

    Position OverviewMedStar Family Choice is in search of a qualified Compliance Coding Auditor to enhance our DC Medicaid Plan team. The ideal candidate must hold a certification in Medical Coding and will be responsible for conducting audits and investigations to ensure adherence to relevant laws and regulations governing the Medicaid Program Integrity.Key...


  • Washington, United States COMPLIANCE WEEK Full time

    Location: Washington, DC (Hybrid) Position Overview Elevate your career as a Senior Compliance Auditor within the Compliance division at Compliance Week. Our compliance team is dedicated to enhancing the organization’s Enterprise Risk Management framework by applying the Institute of Internal Auditors' Three Lines model. In this capacity, we stay aligned...


  • Washington, United States Medstar Full time

    Position OverviewMedStar Family Choice is seeking a qualified Coding Compliance Auditor to support the DC Medicaid Plan team. The ideal candidate must hold a certification in medical coding and will be responsible for conducting audits and investigations to ensure adherence to both District and federal regulations related to the Medicaid Program...


  • Washington, United States COMPLIANCE WEEK Full time

    Location: Washington, DC (Hybrid) Position Overview Elevate your career as a Senior Compliance Auditor within the Compliance division. This unit plays a crucial role in managing the organization's Enterprise Risk Management program, utilizing the Institute of Internal Auditors' Three Lines model. In our operations, we adapt to leading practices, evolving...


  • Washington, United States COMPLIANCE WEEK Full time

    Location: Washington, DC (Hybrid) Position Overview Elevate your career as a Senior Compliance Auditor within the Compliance division. This unit is integral to the organization’s Enterprise Risk Management framework, employing the Institute of Internal Auditors' Three Lines model. Our mission is to adapt to evolving practices, business processes, and the...


  • Washington, United States COMPLIANCE WEEK Full time

    Location: Remote/Hybrid Position Overview Elevate your career as a Senior Compliance Auditor within Compliance Week's auditing division. Our team is dedicated to enhancing the organization's Enterprise Risk Management initiatives, utilizing the Institute of Internal Auditors' Three Lines model. In this role, you will be instrumental in adapting to evolving...


  • Washington, United States MedStar Health Full time

    Regulatory Auditor - Remote OpportunityMedStar Health is seeking a skilled Regulatory Auditor to enhance our compliance efforts. The preferred candidate will possess a CPC Medical Coder certification and demonstrate the ability to operate autonomously in a dynamic work environment. While this role supports remote work, candidates from the DMV Area...


  • Washington, United States MedStar Health Full time

    Regulatory Auditor - Remote OpportunityMedStar Health is seeking a skilled Regulatory Auditor to enhance our operations. The preferred candidate will possess a CPC Medical Coder certification and demonstrate the capability to operate autonomously in a dynamic setting. While this role supports remote work, candidates from the DMV Area (Washington DC,...


  • Washington, United States MH Miles & Company Full time

    Job DescriptionJob DescriptionMH Miles Company, CPA, PC is a certified public accounting firm with offices in Decatur, GA, Douglasville, GA, and Washington, DC. Our firm and its affiliates consist of certified public accountants, certified fraud examiners, management consultants, and support staff who have substantial experience in serving commercial...


  • Washington, Washington, D.C., United States JobTarget Full time

    Washington, DC (901 E)Principal Internal Auditor, Compliance (Hybrid)Position OverviewIgnite your career as Principal Internal Auditor within Pew's Compliance unitPew's compliance unit facilitates the institution's Enterprise Risk Management program leveraging the Institute of Internal Auditors Three Lines model. In executing our program, we keep pace with...


  • Washington, Washington, D.C., United States Pew Charitable Trusts Full time

    Washington, DC (901 E)Principal Internal Auditor, Compliance (Hybrid)Position OverviewIgnite your career as Principal Internal Auditor within Pew's Compliance unit Pew's compliance unit facilitates the institution's Enterprise Risk Management program leveraging the Institute of Internal Auditors Three Lines model. In executing our program, we keep pace with...


  • Washington, United States The Pew Charitable Trusts Full time

    Principal Internal Auditor, Compliance (Hybrid)Position Overview Ignite your career as Principal Internal Auditor within Pew’s Compliance unit!Pew’s compliance unit facilitates the institution’s Enterprise Risk Management program leveraging the Institute of Internal Auditors Three Lines model. In executing our program, we keep pace with leading...


  • Washington, United States ECS Mid-Atlantic, LLC Full time

    Job SummaryWe are seeking a highly skilled Building Code Compliance Specialist to join our team at ECS Mid-Atlantic, LLC. As a key member of our team, you will be responsible for ensuring that our clients' buildings meet the highest standards of safety and compliance.Key ResponsibilitiesConduct thorough building inspections to identify any code compliance...


  • Washington, United States Engineering Consulting Services Full time

    Job SummaryWe are seeking a highly skilled Building Code Compliance Specialist to join our team at Engineering Consulting Services. As a key member of our team, you will be responsible for ensuring that our clients' construction projects meet the highest standards of safety and compliance.Key ResponsibilitiesPerform third-party building inspections to ensure...

  • Revenue Auditor

    12 hours ago


    Washington, Pennsylvania, United States Penn National Gaming Full time

    Job Summary:We are seeking a highly skilled Revenue Auditor to join our team at Penn National Gaming. As a Revenue Auditor, you will play a critical role in ensuring the accuracy and integrity of our financial reporting.Key Responsibilities:Conduct daily audits of cage, slots, table games, gaming, and non-gaming revenue areas to ensure compliance with...


  • Washington, Utah, United States Washington City Full time

    Job OverviewDepartment: Community DevelopmentDivision: Building InspectionSalary Range for Building Inspector 2: $62,110 - $74,532 (DOE)Salary Range for Building Inspector 3: $69,833 - $83,800 (DOE)Certification Requirement: Must be ICC 4 way certified in both Residential and Commercial sectors.General Purpose:- Ensure adherence to building, electrical,...

  • Auditor Specialist

    7 days ago


    Washington, Washington, D.C., United States Vision Achievement Full time

    Job SummaryVision Achievement is seeking a highly skilled Auditor Specialist to join our team. As an Auditor Specialist, you will be responsible for planning and delivering Life Science consulting engagements related to quality/regulatory affairs infrastructure, appropriate to the level of risk in a target product.Key ResponsibilitiesPlan and deliver Life...

  • Building Inspector

    3 days ago


    Washington, United States ECS Limited Full time

    About the RoleWe are seeking a highly skilled Building Inspector - Code Compliance Specialist to join our team at ECS Limited. As a key member of our team, you will be responsible for ensuring that our clients' buildings meet the highest standards of safety and compliance.Key ResponsibilitiesConduct thorough building inspections to identify any defects or...


  • Washington, United States SAFEbuilt Full time

    Job SummaryWe are seeking a highly skilled and experienced Housing Code Inspector III to join our team at SAFEbuilt. As a key member of our organization, you will be responsible for ensuring compliance with local building codes and regulations.Key ResponsibilitiesConduct field inspections to ensure compliance with building codes and regulationsExamine plans...