- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position ... required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims ...monitoring of claims processing compliance for specialty health plans and vendors. This includes medical ,… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor II** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... an accommodation is granted as required by law._ The ** Claims Auditor II** is responsible for audits...various aspects of the claim including eligibility, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… more
- UCLA Health (Los Angeles, CA)
- …Take your career 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,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… more
- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
- WTW (Chicago, IL)
- …a high level of claims administration knowledge, including experience with medical , dental, mental health and Medicare + Detailed knowledge of ICD-10 ... the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment… more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- …and quality management program. **Your future duties and responsibilities:** 1. Reviews medical records to identify recovery opportunities on claims for ... **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main...Healthcare Compliance, Outpatient Coding Team, with responsibility for reviewing medical records to determine the accuracy of coding and… more
- The County of Los Angeles (Los Angeles, CA)
- INTERNAL AUDITOR / ACCOUNTANT- AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4103628) Apply INTERNAL AUDITOR / ACCOUNTANT- ... Angeles County, CA Job Type Full time Job Number S0675I Department AUDITOR -CONTROLLER Opening Date 09/02/2025 Closing Date 9/19/2025 5:00 PM Pacific + Description… more
- Elevance Health (MD)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- Elevance Health (Richmond, VA)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Elevance Health (Hanover, MD)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… 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 - ... choose among a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death and Dismemberment… more
- Elevance Health (Mason, OH)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Actalent (West Des Moines, IA)
- …of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with client contracts and ... Nurse Auditor Job Description This role requires a thorough...documentation. This includes determining accurate payment criteria for pending claims , auditing and pricing a wide variety of claim… 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...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and...Medical Coder (CMC) + OR Registered Health … more
- FlexStaff (Chappaqua, NY)
- **Req Number** 165727 FlexStaff Compliance Auditor - Hybrid position- Chappaqua, NY- $105K *THIS IS A HYBRID POSITION- YOU MUST RESIDE LOCALLY* Are you passionate ... a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...Medical Coder (CMC) + Registered Health Information… more
- MyFlorida (Miami, FL)
- TAX AUDITOR III - 79011031 Date: Sep 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... 860412 Agency: Business and Professional Regulations Working Title: TAX AUDITOR III - 79011031 Pay Plan: Career Service Position...sick leave annually. + The State of Florida offers health insurance coverage (ie individual and family coverage) to… more
- Highmark Health (Harrisburg, PA)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs...internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of… more