- Monroe One Boces (Fairport, NY)
- Internal Claims Auditor JobID: 2168 + Position...class. DUTIES: 1. Verify and audit appropriateness of all claims for payments. 2. Examine all claim ... Type: Support Staff/ Internal Claims Auditor + Date Posted: 6/4/2025 +...they are disbursed. 11. Approve and certify that each claim listed on the warrant was audited and payment… more
- Conduent (Warren, MI)
- …and be part of a culture where individuality is noticed and valued every day. ** Claims Auditor ** **Position is onsite in Warren, MI** Training: Mon- Thur ( On ... multiple claim reviews. **Responsibilities:** + Validate costs for Supplier Claims according to contract Terms & Conditions. + Generate and complete audit… 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...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper category for benefit code...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor . You will review claims (paid, pending,...+ Computer proficiency with Microsoft Office + Knowledge of claims adjudication systems + Flexibility and adaptability… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …including basic analysis of identified trends. + Analyzes audit results to recommend system or procedural changes to increase claim accuracy and/or identify ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Mohawk Valley Health System (Utica, NY)
- Coding Auditor & Educator - Full Time - Department: MEDICAL GROUP ADMINISTRATION Job Summary The Medical Group Coding Auditor and Educator is responsible for ... on coding best practices, documentation requirements, and payer-specific guidelines. The Auditor will apply expertise in coding principles, identify areas for… more
- Commonwealth of Pennsylvania (PA)
- …risk. Levels of Performance Select the Level of Performance that best describes your claim . + A. I have experience performing system testing to ensure ... Auditor 1 Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4964738) Apply Auditor...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… 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...Strong proficiency in coding software, electronic health record (EHR) systems , and healthcare management tools including MS Office. +… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- Billing Auditor for Shared Services Fully Remote * Rochester, Buffalo, or Syracuse, NY * Revenue Cycle Description Billing Auditor for Shared ServicesBuffalo, ... of PPCWNY's mission and the collaboration with Shared Services, the Billing Auditor evaluates Revenue Cycle outcomes to identify and recommend opportunities for… more
- Commonwealth of Pennsylvania (PA)
- …Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information Systems Auditor (CISA) Legal Requirements: + A conditional offer of employment ... to audit every municipality which received general municipal pension system state aid. Work duties include, but are not...Certified Internal Auditor (CIA) + Certified Information Systems Auditor (CISA) + None 09 I… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Civil Service, Department of Title Internal Auditor 1, or Trainee 1 / Trainee 2 Occupational Category Other Professional Careers Salary Grade NS ... and enter member information into NYSHIP's databases. Under the direction of an Internal Auditor 2 the Internal Auditor 1, or Trainee 1 /Trainee 2's duties… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... City Albany State NY Zip Code 12227 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… 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...preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer… 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._...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + ... The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...related activities and services provided by the BayCare Health System HIM Coding Department. + Interacts directly with coders,… more
- Elevance Health (Miami, FL)
- …reviews using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the ... **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
- 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 ... leading the way and has become one of the fastest growing healthcare systems in Kentucky (and beyond!) in addiction treatment, mental health services and improving… more
- UPMC (Pittsburgh, PA)
- …coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes. + Experience in an academic ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
- Highmark Health (Oklahoma City, OK)
- …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more