- 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 ... and apply appeal arguments and draft appeal letters to support and defend the codes assigned by the coding...made by the government or commercial payors, or their auditor representative. Facilitate clinical chart reviews to assist with… more
- Berkley (Manassas, VA)
- …financial information, developing comprehensive workpapers, and coordinating special projects that support the Finance team. Additionally, you will support the ... Be a highly effective user of all financial systems, policy and claims systems, and corporate platforms and tools. Identify and coordinate the resolution… more
- CACI International (Latham, NY)
- …litigation and investigative matters. We are seeking a **Litigation and Investigations Auditor ** to support trial and investigative teams with complex audits ... Litigation and Investigations Auditor Job Category: Finance and Accounting Time Type:...individuals, entities, and assets. + Analyze **large, complex healthcare claims datasets** to detect patterns of fraud, waste, and… more
- Henry Ford Health System (Troy, MI)
- …charge entry, and healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, ... the accounts audited reflect proper documentation, charge capture, coding, and billing to support proper payment. The RI Auditor understands HFH payor contracts… more
- UPMC (Wexford, PA)
- …their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Compliance Auditor , Intermediate to support the office Remotely. Must live in the ... and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + Conduct audits on… more
- Commonwealth of Pennsylvania (PA)
- … Auditor 3 (Local Government) - Allegheny Co Support Admin Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4962984) Apply Field Auditor ... / Division Code 88215000 Bureau / Division Allegheny County Administrative Support Worksite Address One Smithfield Street City Pittsburgh, Pennsylvania Zip Code… 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 ... in accordance with contractual and regulatory obligations + Solicit documentation to support pharmacy claim submission by conducting telephonic, fax or email… 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
- 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
- Centers Plan for Healthy Living (Staten Island, NY)
- …teams to match the unique strengths of each individual, tiered roles to support the advancement, and with opportunities for cross-training and education, CPHL is the ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Commonwealth of Pennsylvania (PA)
- Auditor 1 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5004985) Apply Auditor 1 Salary $51,971.00 - $79,062.00 Annually Location ... of Audits, Liquor Control Board Operations is seeking an Auditor 1 to join our team of professionals. With...will prepare and organize the required documentation necessary to support the conclusions reached and the recommendations made. Apply… 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, ... empowers individuals and families. With respect. Without judgment.No matter what. In support of PPCWNY's mission and the collaboration with Shared Services, the… 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
- City of New York (New York, NY)
- …of Medicaid Providers. Utilize standard audit procedures examine records and documents that support claims submitted to Medicaid for reimbursement for goods or ... Job Description APPLICANTS MUST BE PERMANENT IN THE MANAGEMENT AUDITOR CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE. IF… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The… 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
- ManpowerGroup (Vienna, VA)
- 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) ... Auditor , you will be part of the Audit Services...policies. + Conduct thorough audits of life and death claims to verify accuracy, completeness, and compliance with company… more
- The County of Los Angeles (Los Angeles, CA)
- LAW ENFORCEMENT AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4668332) Apply LAW ENFORCEMENT AUDITOR Salary $109,807.68 - ... audit process. Interviews department personnel and gathers evidence to support and ensure audit results are appropriate and sufficient....No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… 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
- Washington Metropolitan Area Transit Authority (Washington, DC)
- Senior Auditor , Contracts Division, Office of Inspector General Job ID: 250622 Location: DC - L'Enfant Plaza Full/Part Time: Full-Time Posting Open-Close 07/24/2025 ... position either with or without reasonable accommodations. **SUMMARY** The Senior Auditor , Contracts Division is responsible for planning and conducting audits and,… more
