- 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 ... downstream claim corrections and eliminate potential waste. **Responsibilities** + Validate claim documentation and systems data to ensure claim was… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper category for benefit code...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor . You will review claims (paid, pending,...+ Computer proficiency with Microsoft Office + Knowledge of claims adjudication systems + Flexibility and adaptability… more
- Insight Global (Los Angeles, CA)
- Job Description Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in the country. This person will be ... work independently and collaboratively In-depth knowledge of healthcare regulations and claims processing systems Reliable transportation for off-site audits… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …including basic analysis of identified trends. + Analyzes audit results to recommend system or procedural changes to increase claim accuracy and/or identify ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- UC Health (Cincinnati, OH)
- …to advance healing and reduce suffering. As the region's adult academic health system , we strive for innovation and provide world-class care for not only our ... an inclusive, equitable and diverse place of employment. The Charge Master Auditor is responsible for executing charge related audits. They assist in evaluating… more
- Commonwealth of Pennsylvania (PA)
- …risk. Levels of Performance Select the Level of Performance that best describes your claim . + A. I have experience performing system testing to ensure ... Auditor 1 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5004985) Apply Auditor...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- Billing Auditor for Shared Services Fully Remote * Rochester, Buffalo, or Syracuse, NY * Revenue Cycle Description Billing Auditor for Shared ServicesBuffalo, ... of PPCWNY's mission and the collaboration with Shared Services, the Billing Auditor evaluates Revenue Cycle outcomes to identify and recommend opportunities for… more
- Prime Therapeutics (San Diego, CA)
- …procedures and objectives + Leverage professional pharmacy technician knowledge to validate claim documentation and systems data while onsite to ensure ... passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor … 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
- New York State Civil Service (Brooklyn, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... City Brooklyn State NY Zip Code 11201 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- AutoZone, Inc. (Memphis, TN)
- The Sr. Auditor Recovery Auditor will be required to: Utilize analytical and forensic email review skills to audit Merchandising negotiations to recover missed ... 3rd Party vendors to recover less than 10% behind Senior Auditor . Negotiate and communicate flawlessly with Merchandising and Vendors to successfully… 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...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + ... The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...related activities and services provided by the BayCare Health System HIM Coding Department. + Interacts directly with coders,… more
- Elevance Health (Indianapolis, IN)
- …with provider management team by presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and writes report of ... **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
- The Cigna Group (Philadelphia, PA)
- …testing results, identify gaps, and make recommendations to improve processes and the system of internal control over the claim processing operations, including ... Audit function with focus on leading compliance support for Cigna's System and Organization Controls (SOC1) reports over business operations. Responsibilities… more
- General Motors (Washington, DC)
- **Job Description** The individual Dealer Auditor reviews the administration of General Motors policies and procedures as provided in the Dealer Sales and Service ... This review may include dealership practices relative to warranty claims and policy claims . These claims...must comply with specific rules and policies. The Dealer Auditor completes audits onsite at a dealership location and… more
- UPMC (Pittsburgh, PA)
- …coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes. + Experience in an academic ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency SUNY System Administration Title Internal Auditor Occupational Category Financial, Accounting, Auditing Salary Grade NS Bargaining Unit M/C - ... of New York, or SUNY, is the largest comprehensive system of public higher education in the United States,...Conducts the audit under the supervision of a senior auditor by performing various tests, reviews, reconciliations, and evaluations… more
- Elevance Health (Seattle, WA)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more