- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . The **Medical Coding Auditor ** plays a crucial role in ensuring the accuracy and compliance ... leveraging a deep understanding of ICD-10 and other coding standards, the auditor reviews and researches provider diagnostic coding issues, performs detailed medical… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …management, dealing with difficult people, etc. + Quality certification such as Certified Quality Auditor (CQA), Quality Improvement Associate (CQIA), Quality ... as assigned. **What you will bring:** + Four (4) years of customer service, claims or membership and billing experience in a call center, healthcare, or insurance… more
- Lyric (Newtown Square, PA)
- …experience as a medical coder, medical claims adjuster, medical claims processor, chart reviewer/ auditor , denial management analyst, clinical editing ... Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified , and a recipient of the 2025 CandE Award...is vital to the expansion and effectiveness of our claims editing packages and helps ensure payment accuracy. **ESSENTIAL… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …desired. + Auditor Certification preferred (ie American Society for Quality - Certified HACCP Auditor , Certified Quality Auditor , Certified ... CAPAs, Nutritional Documents, COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety & Product Quality audits at… more
- Commonwealth of Pennsylvania (PA)
- …Auditing Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information Systems ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....+ Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified… more
- Commonwealth of Pennsylvania (PA)
- …Auditing Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information Systems ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....+ Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified… more
- Sedgwick (Indianapolis, IN)
- …Major in accounting field strongly preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems ... achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in… more
- MAPFRE Insurance (Webster, MA)
- …+ Bachelor's Degree required. Certified Public Accountant (CPA) designation, Certified Internal Auditor (CIA) designation or Certified Information ... Internal Auditor (Webster or Boston, MA) Date: Nov 22,...designation preferred + 1-2 years of insurance industry knowledge ( Claims , Underwriting, Insurance Operations, etc.)An understanding of internal audit… more
- Huron Consulting Group (Chicago, IL)
- …Coder (CPC) through AAPC + Preferred Certifications: + AAPC CPMA ( Certified Professional Medical Auditor ) + Registered Health Information Administrator ... physician, patient and employee engagement across the enterprise. The Coding Auditor - ambulatory/professional coding/profee will be responsible for auditing of… more
- Rush University Medical Center (Chicago, IL)
- …* Strong communication and organizational skills. **Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) and/or Surgical Coding ... a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of...and/or reduce denials. 3. Reviews charge information submitted by certified coders, claim forms, and insurance correspondence… more
- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment,... has working knowledge of the overall aspects of claim processing, both in and outside of Security Health… more
- Commonwealth of Pennsylvania (PA)
- …Auditing Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) Legal Requirements: + A conditional offer of ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....+ Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + None 08… more
- Quality Technology Services, LLC (Overland Park, KS)
- …CSF), and SOX ITGCs + One or more professional certifications such as Certified Information Systems Auditor (CISA), Certified Information Security Manager ... (CISM), Certified Information Systems Security Professional (CISSP), Certified Internal Auditor (CIA), or similar certifications **Knowledge, Skills &… more
- Eaton Corporation (Sumter, SC)
- …knowledge on Panelboards and Switchboards or similar electrical products + ISO 9001 Internal Auditor . + ASQ Certified Quality Engineer or Certified Quality ... work with the production team to implement corrective actions. + Authorize warranty claims , assign RMA return suffixes, and generate replacement orders for RE … more
- US Tech Solutions (Schenectady, NY)
- …versed with the Nuclear Industry Standards - N299.2, N299.3 + ISO Lead auditor certified by 3rd party registrar or accepted internal client ... NCRs and Service Notices (SN), Provide quality disposition on warranty claims and supplier recoveries, and Supplier Deviation Request (SDR) activities. Owner… more
- UPMC (Pittsburgh, PA)
- …in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part of the… more
- Sedgwick (Dayton, OH)
- …certification such as Certified Information Systems Security Professional (CISSP), Certified Information Systems Auditor (CISA), Certified Information ... achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in… more
- LA Care Health Plan (Los Angeles, CA)
- …any of the following Licenses/ Certifications: Certified Public Accountant (CPA) Certified Internal Auditor (CIA) Certified Management Accountant (CMA) ... data by delegates on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements. Manages complex… more
- Elevance Health (Chicago, IL)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Ashburn, VA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables… more
