- Elevance Health (Indianapolis, IN)
- …provider management team by presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and writes report of the ... **Provider Auditor -** FRD > Audit **Hybrid 1:** This...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …desired. + Auditor Certification preferred (ie American Society for Quality - Certified HACCP Auditor , Certified Quality Auditor , Certified ... CAPAs, Nutritional Documents, COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety & Product Quality audits at… more
- UPMC (Pittsburgh, PA)
- …Inpatient Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
- UPMC (Pittsburgh, PA)
- …Inpatient Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate… more
- Sedgwick (Indianapolis, IN)
- …Major in accounting field strongly preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems ... achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in… more
- MAPFRE Insurance (Webster, MA)
- …+ Bachelor's Degree required. Certified Public Accountant (CPA) designation, Certified Internal Auditor (CIA) designation or Certified Information ... Internal Auditor (Webster or Boston, MA) Date: Aug 24,...designation preferred + 1-2 years of insurance industry knowledge ( Claims , Underwriting, Insurance Operations, etc.)An understanding of internal audit… more
- City of New York (New York, NY)
- …or 2. A valid Certified Public Accountant License or a certificate as a Certified Internal Auditor and four years of full-time experience as indicated in "1" ... Job Description Only permanent Administrative Management Auditor and Incumbent employees are eligible to apply....with vendor contract and/or financial auditing, and auditing of claims for payment to assess their validity on a… more
- Highmark Health (Nashville, TN)
- … Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- State of Colorado (Denver, CO)
- …School Nutrition Specialist (SNS) preferred + Certified Public Accountant (CPA), Certified Internal Auditor (CIA), or Certified Management Accountant ... Nutrition Claims and Finance Consultant Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5083346) Apply Nutrition Claims and Finance… more
- Sedgwick (Nashville, TN)
- …preferred. Major in accounting field preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or Certified Information Systems ... achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in… more
- LA Care Health Plan (Los Angeles, CA)
- …any of the following Licenses/ Certifications: Certified Public Accountant (CPA) Certified Internal Auditor (CIA) Certified Management Accountant (CMA) ... data by delegates on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements. Manages complex… more
- City of New York (New York, NY)
- …license issued by the New York State Education Department; or (C) a valid Certified Internal Auditor certificate issued by the Institute of Internal Auditors ... independently audited financial statements. - Conducting reviews of monthly claims for reimbursement submitted by CBOs, as part of...a Certified Public Accountant license; or a Certified Internal Auditor certificate, as described in… more
- Elevance Health (Richmond, VA)
- …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
- 3M (Monroe, NC)
- …American Society for Quality-ASQ certification(s): Certified Quality Engineer (CQE), Certified Quality Auditor (CQA), Certified Manager of ... qualification, measurement system analysis, supplier management, regulatory compliance, and claim substantiation. The hire will also collaborate with manufacturing… more
- Banner Health (AZ)
- …bring your experience and skills to BPN. As a Health Plan Compliance Auditor , your primary responsibility is to conduct audits by comparing provider medical record ... documentation to claims submitted in the BPN claims system,...billed services. This role involves reviewing medical records, analyzing claim data, and verifying compliance with applicable guidelines. You… more
- Sedgwick (Des Moines, IA)
- …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at...members to jointly meet production objectives/goals. **QUALIFICATIONS** + On-site claims adjusting experience and/or experience as a Claims… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. About the Role: The Professional Auditor is responsible for post-pay review to verify the accuracy of claims ... the Plans' provider agreements and the National Healthcare guidelines. The Professional Auditor helps improve clinical outcomes and quality of care, to reduce… more
- Sedgwick (Annapolis, MD)
- …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- HUB International (Chicago, IL)
- …success in mergers and acquisitions. **ABOUT THE ROLE** **Summary:** The PBM Auditor is responsible for conducting comprehensive audits of Pharmacy Benefit Managers ... (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data analysis, contract… more
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more