- Universal Health Services (Riverside, CA)
- …guidelines and requirements. 2. Daily track and report both financial and clerical claims processing errors in the auditor Access database program, and report ... you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward....and receive care. SUMMARY: Responsible for auditing and training claims staff on all Managed Care claims … more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... healthcare experience that provides our members, their families, ...auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management… more
- HCA Healthcare (Campbell, CA)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Claim Auditor today with HCA Healthcare . **Benefits** HCA Healthcare , offers a ... Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with...by location._** Come join our team as a(an) Claim Auditor . We care for our community! Just last year,… more
- Oak Orchard Health (Brockport, NY)
- …Degree in Business or related field, or public/private payor background preferred. + Licensed Healthcare Auditor (LHA or CPMA) or willing to obtain within the ... Healthcare Compliance Auditor Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420)...of hire + Minimum of 5 years' experience in healthcare , health insurance, enrollment/ claims processing; with proficient… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare 's ... and procedures. The position plays a key role in oversight of Sharp HealthCare 's (SHC) compliance audit function and maintaining Sharp HealthCare 's view of… more
- UCLA Health (Los Angeles, CA)
- …and maintaining a safe and fair learning and work environment. As a Professional Auditor and Trainer, you will help further our mission by providing all UCLA Health ... audits and projects, perform regulatory research, investigations, participate in the claims review process. * Perform Quality Assurance reviews. * Raise instances… more
- Humana (Columbus, OH)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ... medical codes (eg, ICD-10-CM/ PCS) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent… more
- Hackensack Meridian Health (Hackensack, NJ)
- …community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The **Diagnosis Related Group ... (DRG) Auditor ** is responsible for auditing clinical documentation that supports...accuracy, coding consistency and efficiency in filing of inpatient claims . Collaborates with the Clinical Documentation Quality Liaison to… more
- Universal Health Services (Richmond, VA)
- …One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of ... Region CBO is seeking a dynamic and talented Nurse Auditor Team Lead. The Nurse Auditor Team...departmental goals and objectives + Analyze and resolve patient claims being held by billing edits that require clinical… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Lead Investigator ( Auditor ) - Medicaid Fraud** **Job Class: Legal Assistant 8 (LA8)** **Agency: Attorney General's Office** + **Job ID** : 76705 + ... of the Minnesota Attorney General is currently seeking a Lead Investigator - Auditor in the Medicaid Fraud Division of the Office. Investigators within Medicaid… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Auditor and Educator Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's top-performing ... healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) and over 85...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- Hackensack Meridian Health (Hackensack, NJ)
- …community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The **Ambulatory Payment ... Classification (APC) Auditor ** performs all related internal, concurrent, prospective and retrospective coding audit activities across the Hackensack Meridian Health… more
- Elevance Health (Plano, TX)
- **Clinical Medical Records Auditor ** A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving ... home setting. **Location:** Plano, Texas The **Clinical Medical Records Auditor ** is responsible for the audit and review of...include, but are not limited to: + Audits provider claims for compliance to standard coding and billing practice… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Attorney General, Office of the Title Forensic Auditor : Entry Level Opportunity, CPA Not Required (6319) Occupational Category Financial, ... statistical sampling and/or advanced statistical training.* Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 /...ICD-9 / 10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the… more
- Robert Half Management Resources (Los Angeles, CA)
- Description We are in search of a meticulous Sr. Auditor to join our healthcare team in Los Angeles, California. The role involves auditing various aspects of ... our healthcare operations, including hospital departments, billing issues, and charge...and manage documentation * Experience in medical chart and claims audits * Familiarity with auditing practices and procedures… more
- Covenant Health Inc. (Knoxville, TN)
- …to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs ... inpatient and out-patient and/or physician practice. Good working knowledge of healthcare billing, Medicare/Medicaid billing guidelines, and other Third Party Payor… more
- Highmark Health (Jefferson City, MO)
- …Depending on location provides or arranges for education/training of facility healthcare professionals in use of coding guidelines and practices, proper ... Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician...skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and… more
- State of Colorado (Denver, CO)
- …mentor, focusing on investigating and litigating civil violations of Medicaid False Claims Acts at the state and federal levels, and multi-state investigations and ... and litigation unit consisting of six attorneys, thirteen sworn investigators, a forensic auditor , a paralegal, a nurse analyst, and a program assistant. The mission… more
- UNC Health Care (Rocky Mount, NC)
- …to assist in facilitating: 1) clinically related reviews of patient accounts/ claims to ensure compliant billing guidelines (internal and external) are followed ... Facility-based Infusion and Hydration charging), 2) reviews and follow up of claims denied by insurance companies with primary focus on managed-care and commercial… more
- Veterans Affairs, Veterans Health Administration (Memphis, TN)
- …position is located at the Memphis VA Medical Center within the Mid-South Healthcare Network (VISN 9). Serves as Chief, Accounting Section of Fiscal Service and ... standard. Similarly, "accountant" should be interpreted, generally, as "accountant and/or auditor .") OR Combination of education and experience: at least 4 years… more
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