- Medix (Sherman Oaks, CA)
- …a Claims Auditor responsible for ensuring the quality of claims processes and compliance with external regulations and contractual obligations. This role ... suggesting process improvements, and providing information to all staff. Additionally, the Claims Auditor will conduct special projects and support management by… more
- Children's Wisconsin (Milwaukee, WI)
- …https://www.instagram.com/lifeatcw/ Children's Wisconsin has an opportunity for a Senior Revenue Compliance Auditor on our team. Location : Remote What ... Information Management Association, CHC-Certified in Healthcare Compliance - Compliance Certification Board, CIA-Certified Internal Auditor - ISACA,… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... Through our dedicated associates, Conduent delivers mission-critical services and solutions...behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical… more
- UPMC (Pittsburgh, PA)
- …can make a significant impact? **UPMC Corporate Compliance ** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring...and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory… more
- UPMC (Pittsburgh, PA)
- …ensuring compliance in healthcare? **UPMC Corporate Finance** is looking for a dedicated and meticulous ** Compliance Auditor , Associate** to join our ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented...DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post-Audit… more
- Humana (Montgomery, AL)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Elevance Health (Grand Prairie, TX)
- …associated with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- The County of Los Angeles (Los Angeles, CA)
- …health protection, water conservation, cultural activities and many more. We are dedicated professionals committed to preserving the dignity and integrity of the ... easements, licenses, joint developments, and property management, all in compliance with applicable laws (eg, California Environmental Quality Act), rules… more
- St. Luke's University Health Network (Allentown, PA)
- …Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering ... The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure… more
