- Conduent, Inc. (Dallas, TX)
- Job Description Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent ... 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
- City of New York (New York, NY)
- …relating to cost allocation. The Finance Office is recruiting for one (1) Management Auditor II to function as an Administrative Claims Preparer who will: - ... Company Description Job Description APPLICANTS MUST BE PERMANENT...submitted to State Agencies by using the NYS Automated Claim System (ACS). Claims for Federal and… 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)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... 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
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... audits on behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical knowledge and regulatory expertise… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... of our employees have been key factors in our company 's growth and market presence. By hiring the best...of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- Insight Global (Los Angeles, CA)
- …and quarterly reporting (eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating inclusive ... Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in...person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted… more
- NTT DATA North America (Decatur, IL)
- …quality, integrity, and commitment of our employees have been key factors in our company 's growth and market presence. By hiring the best people and helping them ... The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal...skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of… more
- ManpowerGroup (New York, NY)
- …with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify ... Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to... Claims : Conduct thorough audits of life insurance claims , including verifying claim amounts, beneficiary information,… 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)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- ManpowerGroup (Vienna, VA)
- …and death claims to verify accuracy, completeness, and compliance with company policies and industry regulations. + Analyze claims documentation, including ... Our client, is seeking a Bank and Corporate Owned Life Insurance (BOLI/COLI) Auditor to join their team. As a Bank and Corporate Owned Life Insurance (BOLI/COLI) … more
- AutoZone, Inc. (Memphis, TN)
- The Senior Auditor will be required to: Utilize analytical and forensic email review skills to audit Merchandising negotiations to recover missed funding for the ... 3rd Party vendors to recover less than 10% behind Senior Auditor . Negotiate and communicate flawlessly with Merchandising and Vendors to successfully… more
- 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 ** **Location** : Indianapolis, IN **Field:** This field-based...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- Sedgwick (Annapolis, MD)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +… more
- CACI International (Latham, NY)
- Litigation and Investigations Auditor Job Category: Finance and Accounting Time Type: Full time Minimum Clearance Required to Start: Public Trust Employee Type: ... litigation and investigative matters. We are seeking a **Litigation and Investigations Auditor ** to support trial and investigative teams with complex audits and… 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
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
