- 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
- UCLA Health (Los Angeles, CA)
- …an exciting new direction. You can do all this and more at UCLA Health. The Claims Quality Auditor serves as the primary point of contact for submission and ... on a key role within a world-class, award-winning health system . Ensure the efficient delivery of award-winning patient care....Microsoft Word and Excel. + Good working knowledge of claims adjudication systems . UCLA Health welcomes all… 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
- Commonwealth of Pennsylvania (PA)
- Revenue Tax Auditor Trainee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4906528) Apply Revenue Tax Auditor Trainee Salary $55,550.00 - ... new and exciting role. The Erie Regional Section is seeking a motivated Revenue Tax Auditor Trainee with strong attention to detail and a desire to learn the process… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Criminal Justice Services, Division of Title Auditor 1/Trainee Occupational Category Other Professional Careers Salary Grade 18 Bargaining Unit ... Albany State NY Zip Code 12210 Duties Description The Auditor 1, SG-18 will be assigned to the Office...performing various test, reviews, reconciliations, and evaluation of accounts, claims , records, and procedures to ensure that reimbursed costs… 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 (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._...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency State Comptroller, Office of the Title Auditor 1, SG-18, Auditor Trainee 2, (Equated to SG-16), Auditor Trainee 1, (Equated to ... various tests, reviews, reconciliations, analyses and evaluations of accounts, claims , records, and procedures.o Assists in ongoing audit/examination strategy and… more
- BayCare Health System (NC)
- …7:00 AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. This team member must currently reside in ... _Sign on bonuses available!_ **Responsibilities** + The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related activities… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …. Ensure accuracy and integrity of charge data prior to billing interface and claims submission . Utilize a computerized encoding system to facilitate accurate ... and procedural information from the record using ICD-10-CM and CPT-4/HCPCS classification systems . Utilize a computerized encoding system to facilitate accurate… 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 (Independence, OH)
- …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
- Community Health Systems (Springdale, AR)
- **Job Summary** The Compliance Coding Auditor reviews and audits hospital claims to ensure compliant coding, identifying potential risks and opportunities for ... to initiatives focused on ensuring complete and accurate coding. The auditor is responsible for making independent decisions regarding accurate ICD-10-CM,… more
- Catholic Health Initiatives (Chattanooga, TN)
- …with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an ... met at the highest level. The Sr Coding Compliance Auditor 's primary focus will be to facilitate and ensure...other portion of time focused on provider communication, and claims denial resolutions. Communicates denial trends to leadership and… 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
- 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 a Senior Compliance Auditor !** Are you passionate about ensuring accuracy and...and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory… more
- The Cigna Group (Miami, FL)
- Pharmacy Technician Field Auditor - Miami Florida POSITION SUMMARY The Field Auditor is primarily responsible for using analytical skills and audit tools to ... and present findings to key internal and external stakeholders. The Staff Field Auditor will assist in mentoring and developing less experienced Audit Team Members.… more
- US Capitol Police (Washington, DC)
- …audits. Possess a relevant professional certification to include Certified Information Systems Auditor (CISA), Certified Information Systems Security ... 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 (Harrisburg, PA)
- …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
- Elevance Health (Norfolk, VA)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more