- Robert Half Accountemps (Los Angeles, CA)
- Description The Claims Auditor reports functionally to the Administrative Manager but takes most direction from the Claims Manager . The Claims ... claims as needed upon request of Clams Manager . The Auditor will be responsible for...conduct daily audits, focus audits, and random audits of claim payment as established in the Claims … more
- 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: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various...Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT),… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- Commonwealth of Pennsylvania (PA)
- …OF WORK As a Field Auditor 3, you will be assisting the Compliance Manager in developing fiscal compliance work programs to be used for the review of provider ... Field Auditor 3 (Local Government) - Allegheny Co Support...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Elevance Health (Norfolk, VA)
- …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 enables associates to...Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (St. Louis, MO)
- …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
- Trinity Health (Syracuse, NY)
- …payment models. . Identify coding discrepancies and work with risk adjustment auditor / manager to communicate deficiencies to providers. Core Values: . Reverence: ... diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system...support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. . Demonstrate a solid… more
- Mohawk Valley Health System (Utica, NY)
- …+ Work with billing, compliance and revenue cycle teams to ensure proper claims submission and resolve coding-related claim rejections and denials. + Keep ... Supervisor Coding Auditor & Educator - Full Time - Days...Promote effective teamwork throughout the department. + With the Manager and Human Resources guidance, make recommendations or decisions… more
- Elevance Health (Miami, FL)
- …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
- 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 - ... law enforcement operations. This classification acts as a project manager and is distinguished by its role in providing...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- 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 ... judgment. Performs other duties as needed. Reports to the Revenue Integrity Manager . Recruiter: Kathleen Rice || ###@covhlth.com || ### Responsibilities Integrity +… more
- Elevance Health (Costa Mesa, CA)
- **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
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …Boars Head Brand. Complete special projects as assigned by the Sr. QA Manager . Job Description: Essential Duties and Responsibilities + Provide advanced super user ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...able to attend a training course. + Serve Safe Manager Certification or be able to attend a training… more
- Elevance Health (Hanover, MD)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ This field-based role enables associates to primarily operate in the ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Highmark Health (Oklahoma City, OK)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …you will assist with special projects as directed by the Senior QA Manager . Job Description: Essential Duties and Responsibilities + Conduct Food Safety and Product ... product specifications, allergen forms, weight and tare information, and other product claims , as applicable. + Maintain accurate supplier information in the QMS… more
- City of New York (New York, NY)
- …30-30 Thomson Ave, LIC, Queens 11101 As the City's primary capital construction project manager , we build many of the civic facilities New Yorkers use every day. We ... 4500 payment requests annually. DDC seeks a Capital Payment Auditor to review and process these payment requisitions. To...(in FMS3); and adjust payment voucher(s) due to liens, claims and assignments. The candidate will use the DDC… more
- AIG (Charlotte, NC)
- …Policies (GPO), Domain Name Services (DNS), and multiple Quest products, such as Change Auditor and Recovery Manager . In this role, you will be responsible for ... supporting and implementing Active Directory security related products, such as Quest Change Auditor , Enterprise Reporter and Recovery Manager , or similar + 4+… more
- Ross Stores, Inc. (Dublin, CA)
- …reconciliations, Real Estate Taxes and Insurance\. Furthermore, to assist the Property Manager with special projects, while assisting the department to meet its ... if lease requirements have been met\. Draft and send claim letters\. Calculate and pay Substitute Rent if a...Tie out Landlord receivable balances by isolating overcharges, audit claims , misapplied checks, and unpaid charges\. * Contribute to… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours Mercy ... Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors… more