- Elevance Health (Norfolk, VA)
- …using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the findings ... **Provider Auditor ** _This position will work a hybrid model...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: Sep 22,...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
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Claims Auditor **Cost Center:** 682891379 SHP- Claims **Scheduled Weekly ... (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment,... has working knowledge of the overall aspects of claim processing, both in and outside of Security Health… 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
- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . As a **Payment Integrity Auditor II** , you will support the overall objectives of the ... role will support the execution of Premera's corporate wide claim payment accuracy strategy through conducting claim ...coding education material for internal and external audiences. The Auditor II plays a critical role in identifying audit… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Civil Service, Department of Title Internal Auditor 1, or Trainee 1 / Trainee 2 Occupational Category Other Professional Careers Salary Grade NS ... into NYSHIP's databases. Under the direction of an Internal Auditor 2 the Internal Auditor 1, or...letter of eligibility with your response.55 B/C QUALIFICATIONS: Individuals certified eligible for the 55 B/C program under the… 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
- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . As a **Payment Integrity Auditor I** , you will support the overall objectives of the ... Integrity office. This role is responsible for conducting pre-payment and post-payment claim audits to identify improper payments due to billing errors, coding… more
- Option Care Health (Bannockburn, IL)
- …familiarity with statistical methodologies. + Certified in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), ... to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and to identify… more