- Catholic Health Initiatives (Chattanooga, TN)
- …Coders (AAPC) as a Certified Professional Coder (CPC) required. Professional Medical Auditor Certification (CPMA) (CMAS)-preferred but not required. CRC ... with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …be able to attend a training course. + SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...- Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …Registrations + Valid Driver's License with acceptable motorist history required. + Auditor Certification required (ie American Society for Quality - Certified ... allergen forms, weight and tare information, and other product claims , as applicable. + Maintain accurate supplier information in...Food Safety & Quality Auditor , Certified Supplier Quality Professional and/or able to obtain… more
- Conduent (Orlando, FL)
- …a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification ?** **Would you like to ... 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
- US Pacific Fleet (CA)
- …You will be required to obtain and maintain a current ISO 9000:2008 Internal Auditor certification . + You will be required to wear personal protective equipment ... above to see if any are required. If you claim membership, license, certification , or credentials, you...see what is allowed and what is required. Any claims you make in your resume or assessment questionnaire… more
- Rush University Medical Center (Chicago, IL)
- …each case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Exemplifies… more
- Elevance Health (Tampa, FL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- ManpowerGroup (Vienna, VA)
- …of life insurance products + In-depth knowledge of life insurance products, claims processes, and regulatory compliance requirements. + Certification in ... seeking a Bank and Corporate Owned Life Insurance (BOLI/COLI) Auditor to join their team. As a Bank and...policies. + Conduct thorough audits of life and death claims to verify accuracy, completeness, and compliance with company… more
- Elevance Health (Independence, OH)
- …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
- UPMC (Pittsburgh, PA)
- …Care departments related to audit processes and results. The Clinical FWA Auditor /Analyst utilizes claims analysis, document review and applies FWA detection ... Health Plan has an exciting opportunity for a Clinical Auditor /Analyst position in the CCBH Fraud, Waste & Abuse...in identifying trends related to potential inappropriate submission of claims by providers and participates with the other team… more
- Elevance Health (Columbus, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ Alternate locations may be considered. This position will work in a ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Elevance Health (South Portland, ME)
- **Clinical Provider Auditor II** _Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will live ... recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Provider Auditor II is responsible for identifying issues and/or entities that may… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …related to Service Organization Controls (SOC1) reports over the Company's claims processing system. . Plans, monitors, and supervises procedures necessary to ... of management experience. . Public accounting experience preferred. Professional Certification (s): . Certified Public Accountant (CPA) required. . Certified Internal… more
- US Capitol Police (Washington, DC)
- …statement, information technology, or performance audits. Possess a relevant professional certification to include Certified Information Systems Auditor (CISA), ... efficiency and/or achievement of program results; and (b) selected claims , costs, cost proposals, and cost and pricing data...a team member of audits led by a higher-graded auditor . The audits conducted may involve financial records and… more
- Highmark Health (Columbus, OH)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... as assigned. **QUALIFICATIONS:** Minimum + High school diploma / GED + Certification from American Academy of Professional Coders (AAPC) or American Health… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …a dedicated Coding Auditor to join our team and perform thorough claims payment quality and clinical coding compliance audits\. Your role will be pivotal in ... or facility inpatient/outpatient coding and auditing experience\. Current AHIMA or CPC certification is required, or the ability to acquire CPC within one year… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
- Ontario ARC (Canandaigua, NY)
- …USA | Hourly | 21.60-23.00 per hour | Full Time The Arc Ontario Internal Auditor - Programs Salary: $21.60 - $23.00 Position Overview: We're looking for an Internal ... Auditor to join our team and help ensure our...and run efficiently. In this role, you'll audit billing claims , review Individual Service Plans, conduct site visits, and… more
- CareOregon (Portland, OR)
- …for remote positions must reside in Oregon or Washington. Job Title Coding Auditor Requisition # 24856 Exemption Status Exempt Management Level n/a Direct Reports ... in Oregon or SW Washington. Job Summary The Coding Auditor performs code audits and is responsible for chart...that complete and accurate diagnosis codes are captured in claims and retrospective chart review data. + Communicate audit… more
- Avera (Sioux Falls, SD)
- …you will do** + Review, analyze and determine eligibility of contract pharmacy claims by investigating patient records in hospital EMR to ensure each prescription ... meets the 340B patient definition. + Reverse ineligible claims within pharmacy reprocessing window. + Communicate audit results with the Pharmacy Business &… more