- Robert Half Accountemps (Los Angeles, CA)
- Description The Claims Auditor reports functionally to the Administrative Manager but takes most direction from the Claims Manager. The Claims Auditor ... Auditor will be responsible for the monitoring of claims to ensure compliance with the Summary Plan Description,...standards dictated by the Department Policies and Procedures. Requirements Medical Claims , IPA, Claims Adjudications… more
- 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...tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health… 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
- 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
- LA Care Health Plan (Los Angeles, CA)
- Senior Health Plan Auditor Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... achieve that purpose. Job Summary The Senior Health Plan Auditor is a hybrid role and is responsible all...and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors.… more
- Elevance Health (Los Angeles, CA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... and skill development. 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
- Elevance Health (Los Angeles, CA)
- **Performance Quality Analyst III ( Claims ** ) **Location** : This role requires associates to be in-office 1 days per week, fostering collaboration and connectivity, ... locations may be considered. The **Performance Quality Analyst III ( Claims ** ) is responsible for driving service quality excellence...you will make an impact** : + Acts as auditor in charge for audits and special projects, producing… 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
- LA Care Health Plan (Los Angeles, CA)
- …the safety net required to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address ... appropriate claims and financial compliance criteria for specialty health plans....Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- The Walt Disney Company (Burbank, CA)
- …programs such as subscriptions, and actively assisting in settling audit claims through detailed analyses and presentation decks. The team works closely ... early birds, mid-week, etc). Supports the settling of audit claims and estimates potential future audit claims ...experience in finance, business planning, as an accountant or auditor or other quantitative field + Excellent logic, math… more
- The County of Los Angeles (Los Angeles, CA)
- …(CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In ... addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency response system, as well as… more
- The County of Los Angeles (Los Angeles, CA)
- …and division managers for final approval. + Reviews and approves all requests to auditor controller for payments to confirm the requests are accurate and provide the ... steps to view correspondence, and we will not consider claims of missing notices to be a valid reason...may be required to submit documentation from a qualified medical provider or other qualified professional to support your… more
- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... and Special medical aid programs or prepares yearly budget requests, annual...for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations… more
- The County of Los Angeles (Los Angeles, CA)
- …payments, preparing invoices for services rendered, processing employee expense claims for reimbursements, cash receipts and reimbursing revolving funds. Apportions ... assets. Reviews trial balances of accounts and reconciles to the Auditor -Controller's Countywide Accounting and Purchasing System (eCAPS) and subsidiary ledgers and… more
- The County of Los Angeles (Los Angeles, CA)
- …requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more
- Molina Healthcare (Los Angeles, CA)
- …Medicare/MMP + Develop custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and collaborates with ... License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested in applying… more