- Insight Global (Los Angeles, CA)
- Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in the country. This person will be responsible for for ... work independently and collaboratively In-depth knowledge of healthcare regulations and claims processing systems Reliable transportation for off-site audits… more
- Valley View (Glenwood Springs, CO)
- …View Hospital is seeking a qualified individual to work as a full-time Billing Auditor in our Patient Financial Services department. This is a REMOTE position! The ... objectives of this position are to: coordinate Commercial billing, ensuring clean claims are sent out; demonstrate extensive methodology and knowledge to produce… more
- Solugenix (Los Angeles, CA)
- Financial Compliance Auditor III, Claims Los Angeles, CA (Remote) 3-Month Contract Job ID 25-09703 Solugenix is assisting a client, a health insurance company, ... in their search for a Financial Compliance Auditor III, Claims . This is a 3-month...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …pivot from a "job" opportunity to an authentic experience! The Lead Compliance Auditor leads comprehensive audits and conducts key activities of the IEHP Compliance ... with one or more of the following areas: Utilization Management, Claims , Pharmacy Operations, Compliance, Delegation Oversight, Quality Management, Care Management,… more
- StateJobsNY (Binghamton, NY)
- Duties Description Auditor 1 (Tax) performs on-site field audits and examinations of taxpayers' books, records, and substantiating data to determine compliance with ... the Audit Division and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness for the Department to… more
- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure ... determination made by the government or commercial payors, or their auditor representative. Facilitate clinical chart reviews to assist with supporting assigned… more
- Lucky Vitamin (Bloomingdale, IL)
- …projects, and documents to assist in accessing information. Ability to demonstrate system compliance to a regulatory auditor . Strong problem-solving skill set, ... OSHA ready. Partners with HR Business Partners to manage work compensation claims . Partners with recruiting on pre-employment functional testing to ensure new… more
- Berkley (Manassas, VA)
- …and accuracy. System Proficiency: Be a highly effective user of all financial systems , policy and claims systems , and corporate platforms and tools. ... Identify and coordinate the resolution of system issues. Efficiency and Value Assessment: Continually assess the business value and efficiency of work performed.… 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 ... 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
- New York State Civil Service (Syracuse, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... authority;* Represent CID and advocate disputed cases at BCMS conferences and Small Claims Hearings; may participate at hearings as a witness for the Department to… more
