- Centene Corporation (Jefferson City, MO)
- …process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into ... the credentialing subsystem + Develop and maintain the audit schedule + Audit staff as outlined in the system auditing policies + Train audit staff at the health plan in the use of audit process and tools + Facilitate compliance with the auditing process + Act… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical ... direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments.… more
- Ameren (Steedman, MO)
- …of electricity for Ameren Missouri's 1.2 million customers. **Our benefits include:** + Medical coverage on date of hire + 100% employer paid cash balance pension ... conducted in compliance with the Operating Quality Assurance Program (OQAP). NOS Auditor positions provide this verification through assessment of the adequacy of… more
- Sedgwick (Jefferson City, MO)
- …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
- CAI (Jefferson City, MO)
- Compliance Auditor **Req number:** R6613 **Employment type:** Full time **Worksite flexibility:** Remote **Who we are** CAI is a global technology services firm with ... in bringing neurodiversity to the enterprise. **Job Summary** As the Compliance Auditor , you will focus on trade compliance operations, ensuring timely and lawful… more
- Datavant (Jefferson City, MO)
- …As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate ... client-based notes. + Maintain communication with both Coders as well as management on errors, trends, educational opportunities, etc. + Other tasks required by… more
- Datavant (Jefferson City, MO)
- …efficient, and positive manner + Adhere to the American Health Information Management Association's code of ethics. + Must be customer-service focused and exhibit ... and other prevalent EMRs. **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off,… more
- Datavant (Jefferson City, MO)
- …quality, compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role, you will ... the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma...apply **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references… more
- CVS Health (Jefferson City, MO)
- …+ 5-7 years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management (UM) and Case ... Eastern and Central time zones._ **Job Summary:** The NCQA Accreditation Auditor is responsible for evaluating healthcare organizations' compliance with NCQA… more
- Datavant (Jefferson City, MO)
- …quality, compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role, you will ... the future of healthcare from your own workspace! Seeking a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings… more
- Coinbase (Jefferson City, MO)
- …within one of the following areas: Information Security, IT governance, risk management or application security. *What you'll be doing (ie. job duties):* * ... from beginning to end. Key activities include audit planning, stakeholder management , fieldwork execution, reporting and validation of remediated audit findings. *… more
- Western Digital (Jefferson City, MO)
- …global operations, support the company's SOX program, and help strengthen IT risk management practices in alignment with WD's enterprise strategy and "Built to Win" ... control deficiencies, root causes, and actionable recommendations, ensuring timely management remediation. + Support coordination with external auditors (KPMG) to… more
- Cardinal Health (Jefferson City, MO)
- …pharmaceuticals and specialty products; a global manufacturer and distributor of medical and laboratory products; an operator of nuclear pharmacies and manufacturing ... system back-up and disaster recovery plans, conducts incident responses, threat management , vulnerability scanning, virus management and intrusion detection as… more
- Coinbase (Jefferson City, MO)
- …to objectively evaluate and audit the effectiveness of governance, compliance, risk management , and control process. The in-house Coinbase Internal Audit team is ... for strategic analysis, risk assessments, development of the audit plan, project management , quality review, report issuance and issue validation across IT and… more
- Merck (Jefferson City, MO)
- …audits, generates audit reports, communicates results to the relevant QA management and external relevant stakeholders (eg Clinical Operations), and interacts with ... QA, exemplifies our Company's Leadership behaviors **Responsibilities relative to the Auditor Resourcer include:** + Support, advance, and drive the Clinical Quality… more
- Hilton (Jefferson City, MO)
- …Brands team of industry experts in the domains of hospitality, brand management , innovation, food and beverage, wellness, owner relations, and more, for all ... and elevate the guest experience? As a Manager, Quality Assurance \(QA\) Auditor , you'll help strengthen and grow Hilton's portfolio\. Reporting to the Area… more