• Financial Compliance Auditor III…

    LA Care Health Plan (Los Angeles, CA)
    Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial… more
    LA Care Health Plan (04/05/25)
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  • Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... and procedures. + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (05/10/25)
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  • Pharmacy Claims Auditor CPhT

    Conduent (Dallas, TX)
    …pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against ... of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to… more
    Conduent (05/31/25)
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  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
    Centers Plan for Healthy Living (04/15/25)
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  • Nurse Auditor /Rev Intgty Spec

    Chesapeake Regional Healthcare (Chesapeake, VA)
    Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising the… more
    Chesapeake Regional Healthcare (04/05/25)
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  • Forensic Auditor : Investigate…

    New York State Civil Service (Rochester, NY)
    NY HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Healthcare Fraud (6391) Occupational Category Financial, Accounting, ... Description Criminal Justice Division Medicaid Fraud Control Unit-Rochester Forensic Accountant/ Auditor Reference No. MFCU_ROC_FAA_6391Salary is $66,964To be considered for… more
    New York State Civil Service (06/05/25)
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  • Forensic Auditor : Investigate…

    New York State Civil Service (Syracuse, NY)
    NY HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Healthcare Fraud (6390) Occupational Category Financial, Accounting, ... analysts, nurses, and legal support analysts to conduct complex, long-term healthcare fraud investigations.The Medicaid program provides health coverage to millions… more
    New York State Civil Service (05/17/25)
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  • Coding Auditor & Educator - Full time…

    Mohawk Valley Health System (Utica, NY)
    Coding Auditor & Educator - Full time - Days Department: MEDICAL GROUP ADMINISTRATION Job Summary The Medical Group Coding Auditor and Educator is responsible ... on coding best practices, documentation requirements, and payer-specific guidelines. The Auditor will apply expertise in coding principles, identify areas for… more
    Mohawk Valley Health System (05/19/25)
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  • Supv Coding Auditor & Educator

    Mohawk Valley Health System (Utica, NY)
    SUPV CODING AUDITOR & EDUCATOR Department: MEDICAL GROUP ADMINISTRATION Job Summary The Supervisor Coding Audit and Education is responsible for overseeing medical ... and education initiatives within the Medical Group. This role supervises Coding Auditor & Educators and conducts coding audits, ensuring adherence to national… more
    Mohawk Valley Health System (05/10/25)
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  • Inpatient DRG Quality Auditor

    Humana (Des Moines, IA)
    …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
    Humana (05/30/25)
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  • Compliance Auditor

    Addiction Recovery Care (Lexington, KY)
    …provision of care, proper documentation of services, and the billing and coding of claims . The Compliance Auditor assists the VP of Compliance and other ... way and has become one of the fastest growing healthcare systems in Kentucky (and beyond!) in addiction treatment,...of everything we do! We are hiring a Compliance Auditor for our growing team! The Compliance Auditor more
    Addiction Recovery Care (05/15/25)
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  • Compliance Auditor , Intermediate (Cemc,…

    UPMC (Pittsburgh, PA)
    **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out of… more
    UPMC (04/11/25)
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  • Compliance Auditor , Senior I (Cemc, CPC,…

    UPMC (Pittsburgh, PA)
    **Join UPMC Corporate Compliance as a Senior Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... impact? UPMC Corporate Compliance is seeking a dedicated and detail-oriented **Senior Compliance Auditor ** to join our team! This position will be based out of… more
    UPMC (04/11/25)
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  • DRG Coding Auditor

    Elevance Health (Chicago, IL)
    **DRG CODING AUDITOR ** **Location** : _This position will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR ** is responsible for ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (05/29/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    …systems/tools to accurately document determinations and continue to next step in the claims lifecycle. + Researches new healthcare related questions as necessary ... **Clinical Provider Auditor II** **Hybrid 1:** This role requires associates...abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
    Elevance Health (05/29/25)
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  • Rev Integrity Auditor Sr

    Covenant Health Inc. (Knoxville, TN)
    Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift In person training with work from home option, at Manager's discretion, after ... Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and… more
    Covenant Health Inc. (05/05/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... onboarding and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure… more
    Elevance Health (06/04/25)
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  • Clinical Provider Auditor II - Maryland…

    Elevance Health (Hanover, MD)
    …systems/tools to accurately document determinations and continue to next step in the claims lifecycle. + Researches new healthcare related questions as necessary ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
    Elevance Health (05/29/25)
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  • Compliance Auditor , Associate

    UPMC (Pittsburgh, PA)
    **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare ? **UPMC ... Corporate Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is crucial in maintaining the integrity… more
    UPMC (04/24/25)
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  • CPC Certified Medical Coding Auditor

    Robert Half Management Resources (Raleigh, NC)
    Description We are looking for an experienced Medical Coding Auditor to join our team on a contract basis in a fully remote capacity. In this role, you will be ... summarizing audit findings, opportunities, and risks. * Provide insights into healthcare revenue cycle processes and recommend strategies for improvement. * Evaluate… more
    Robert Half Management Resources (05/28/25)
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