- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... safety net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution,… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor II** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... an accommodation is granted as required by law._ The ** Claims Auditor II** is responsible for audits...various aspects of the claim including eligibility, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- Conduent (Los Angeles, CA)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… more
- WTW (Chicago, IL)
- …PPO, Indemnity and Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical , dental, mental health and ... **Description** As a Lead Auditor you will apply your audit, project management...will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report.… more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- …and quality management program. **Your future duties and responsibilities:** 1. Reviews medical records to identify recovery opportunities on claims for ... **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main...Healthcare Compliance, Outpatient Coding Team, with responsibility for reviewing medical records to determine the accuracy of coding and… 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...a list of employee benefits, including the following: + Medical and Dental coverage + Group life insurance +… more
- ManpowerGroup (Vienna, VA)
- …and compliance with company policies and industry regulations. + Analyze claims documentation, including medical records, death certificates, policy terms, ... Our client, is seeking a Bank and Corporate Owned Life Insurance (BOLI/COLI) Auditor to join their team. As a Bank and Corporate Owned Life Insurance (BOLI/COLI) … 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 - ... a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- Actalent (West Des Moines, IA)
- …of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with client contracts and ... Nurse Auditor Job Description This role requires a thorough...documentation. This includes determining accurate payment criteria for pending claims , auditing and pricing a wide variety of claim… more
- Sedgwick (Annapolis, MD)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
- Robert Half Accountemps (Boston, MA)
- Description We are looking for a highly skilled RN Auditor to join our team in Boston, Massachusetts. This RN Auditor position offers a long-term contract ... opportunity for a detail-oriented individual with a strong background in auditing, claims administration, and compliance within the healthcare sector. The ideal RN … more
- Elevance Health (Richmond, VA)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… 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
- City of Columbus (Columbus, OH)
- Income Tax Auditor I - EXAM Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/5048861) Apply Income Tax Auditor I - EXAM Salary $28.43 - ... position Job Type Full-time Job Number 25-0660-C1 Department 22 Columbus City Auditor Division Division of Income Tax Opening Date 08/20/2025 Closing Date 9/15/2025… more
- Elevance Health (Hanover, MD)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- Sedgwick (Indianapolis, IN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Internal auditor **PRIMARY PURPOSE OF THE ROLE:** To perform internal audit procedures under ... accounting field strongly preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems Auditor (CISA)… more
- Elevance Health (Des Moines, IA)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **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… more