- Memorial Healthcare System (Hollywood, FL)
- …Works closely with inpatient and outpatient coding managers to analyze and resolve claim denials that are rejected by edits from the Revenue Cycle Department. ... (3), RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR Education and Certification Requirements: Accredited Program: Health Information Management (Required)Certified Coding… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …be able to attend a training course. + SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...- Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …Registrations + Valid Driver's License with acceptable motorist history required. + Auditor Certification required (ie American Society for Quality - Certified ... allergen forms, weight and tare information, and other product claims , as applicable. + Maintain accurate supplier information in...Food Safety & Quality Auditor , Certified Supplier Quality Professional and/or able to obtain… more
- Prime Therapeutics (Denver, CO)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims ... Auditor is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting downstream … more
- Conduent (Los Angeles, CA)
- …a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification ?** **Would you like to ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …as a Quality Assurance Manager in a manufacturing setting + A Certified Aerospace Auditor certification is preferred + Qualified candidates must be an ASQ ... Certified Manager of Quality/OE, Certified Quality Auditor or a Certified Quality Inspector + Experience with...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- NTT DATA North America (Decatur, IL)
- …Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and ... UM process which includes initiating Case Management, requesting Pre- Certification , submitting Medical Reviews, and Independent Dispute Resolution. The successful… more
- Commonwealth of Pennsylvania (PA)
- Auditor 1 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5004985) Apply Auditor 1 Salary $51,971.00 - $79,062.00 Annually Location ... of Audits, Liquor Control Board Operations is seeking an Auditor 1 to join our team of professionals. With...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Prime Therapeutics (San Diego, CA)
- …passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor ... pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting… more
- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- ManpowerGroup (Vienna, VA)
- …of life insurance products + In-depth knowledge of life insurance products, claims processes, and regulatory compliance requirements. + Certification in ... seeking a Bank and Corporate Owned Life Insurance (BOLI/COLI) Auditor to join their team. As a Bank and...policies. + Conduct thorough audits of life and death claims to verify accuracy, completeness, and compliance with company… more
- Henry Ford Health System (Troy, MI)
- …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Auditor must have a comprehensive understanding of medical terminology, coding, charge ... entry, and healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, coding, billing… more
- Humana (Montgomery, AL)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Washington Metropolitan Area Transit Authority (Washington, DC)
- Senior Auditor , Contracts Division, Office of Inspector General Job ID: 250622 Location: DC - L'Enfant Plaza Full/Part Time: Full-Time Posting Open-Close 07/24/2025 ... progressively responsible experience in auditing, taxation and financial analysis. ** Certification /Licensure** + N/A **Preferred** + A Certified Public Accountant… more
- Sharp HealthCare (San Diego, CA)
- …End Time** Certified Health Care Compliance (CHC) - Compliance Certification Board; Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides ... and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's)… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Highmark Health (Harrisburg, PA)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... as assigned. **QUALIFICATIONS:** Minimum + High school diploma / GED + Certification from American Academy of Professional Coders (AAPC) or American Health… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Coding Auditor and Educator, Centralized Coding Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is East ... to ensure compliance. + + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + + Performs… more
- City and County of San Francisco (San Francisco, CA)
- …Professional certification as a Certified Public Accountant, Certified Internal Auditor , or Certified Fraud Examiner. + A Master's degree in public ... effective operations within the Commission. Auditors also play a key role in reviewing claims for public financing to ensure that City funds are only distributed to… more
- AnMed Health (Anderson, SC)
- …SPECIFIC DUTIES MAY INCLUDE: + Conduct pre-submission review of a minimum of five claims per provider on an annual basis + Conduct pre-submission review of a minimum ... of five claims and meet with all new AnMed providers within...diploma or GED required + Certified professional coder (CPC) certification required + Minimum of 2 years CPT, HCPCS… more
