- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... accuracy, and work with the MPS Call Center Manager/Supervisor/Team Lead and analyze the data for training purposes. +...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor II** **Location :** This...is designed to advance our strategy but will also lead to personal and professional growth for our associates. ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor II** is responsible for audits of high dollar claims across… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- City of New York (New York, NY)
- …a high level to ACS' Senior leadership, auditees and stakeholders. Responsibilities for the Lead Auditor /Supervisor will include but may not be limited to: - ... with vendor contract and/or financial auditing, and auditing of claims for payment to assess their validity on a...who are currently serving permanently in the title of Lead Auditor /Supervisor or reachable on the … more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Agriculture & Markets, Department of Title Auditor 1 or Trainee (NY HELPS) Occupational Category Other Professional Careers Salary Grade 18 ... State Department of Agriculture and Markets is seeking an Auditor 1 or Trainee to work in Albany. The...integrity of the tax credit mid-year advance and year-end claims . Specific duties and responsibilities include but are not… more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Tennessee, Knoxville **Alternate Location(s):** ... ID:** J0925-0302 **Employment Type:** Full Time **Position Description:** The OP Coding Auditor is a member of the CGI Healthcare Compliance, Outpatient Coding Team,… more
- The County of Los Angeles (Los Angeles, CA)
- INTERNAL AUDITOR / ACCOUNTANT- AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4103628) Apply INTERNAL AUDITOR / ACCOUNTANT- ... CA Job Type Full time Job Number S0675I Department AUDITOR -CONTROLLER Opening Date 09/02/2025 Closing Date 9/19/2025 5:00 PM...so may result in an incomplete application and may lead to disqualification. We will send notifications to the… more
- Elevance Health (Richmond, VA)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
- Elevance Health (Hanover, MD)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Elevance Health (Des Moines, IA)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- FlexStaff (Chappaqua, NY)
- **Req Number** 165727 FlexStaff Compliance Auditor - Hybrid position- Chappaqua, NY- $105K *THIS IS A HYBRID POSITION- YOU MUST RESIDE LOCALLY* Are you passionate ... a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the… more
- TEKsystems (Los Angeles, CA)
- …with a passion for healthcare claims and compliance? Join our team as a Claims Compliance Auditor , where you'll play a pivotal role in ensuring accuracy, ... efficiency, and regulatory alignment across our claims operations. In this role, you'll: + Lead audits and compliance reviews for HMO and Medicare claims +… more
- Trinity Health (Columbus, OH)
- …at 3100 Easton Square Pl Suite 300, Columbus, OH 43219 **Position Purpose:** Delegated Claims Auditor executes, in an accurate and timely manner, in accordance ... You Will Do:** + Maintain current knowledge of the claims operating system + Sort and organize incoming mail...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
- The County of Los Angeles (Los Angeles, CA)
- …systems. + Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the preparation of reports to support requests ... professional auditing or accounting experience** at the level of Senior Accountant- Auditor , Senior Accounting Systems Technician , Senior Accounting Systems Analyst… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …QUALITY ASSURANCE MANAGER (PLTX) Bowhead seeks a Quality Assurance Manager to lead Bowhead Manufacturing & Product's Quality Management System. The position is ... Manager in a manufacturing setting + A Certified Aerospace Auditor certification is preferred + Qualified candidates must be...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Danaher Corporation (Richmond, IL)
- …cross-functional project teams and regulators. + Certifications preferred: Quality Management, Quality Auditor , Lead Auditor , Six-Sigma Black Belt, Quality ... and the Leica Biosystems Business Units (BUs), to ensure compliance. This position will also lead the quality activities at the SU service and repair shop out of the… more
- Medical Mutual of Ohio (OH)
- …To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data ... + Participates in required training and performs other duties as assigned. ** Lead HEDIS Analyst** + Schedules, assigns, and monitors projects and prioritizes work… more
- State of Arkansas (Little Rock, AR)
- …community, DPSQA, and sister state agencies. Job Summary: Review Incident and Accident claims as assigned by the lead investigator Perform a thorough ... policies and procedures to program participants Attend and present information on claims investigated to DPSQA's I&A Committee Represent DHS as a witness at… more
- The County of Los Angeles (Los Angeles, CA)
- …and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more