- UCLA Health (Los Angeles, CA)
- …career to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners ... assigned to the auditor . You will review claims (paid, pending,...maintain statistical data consistent * Maintain departmental production and quality standards Note: This posted position is 1 of… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten...keep up to date with departmental changes in conducting quality reviews. + Ensure the consistent use of current ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Elevance Health (Norfolk, VA)
- …you a check, or ask you for payment as part of consideration for employment. **Performance Quality Auditor II** + Job Family: QLT > Audit + Type: Full time + ... 02, 2024 + Reference: JR114328 **Location:** + VA, NORFOLK **Description** **Performance Quality Auditor II** **Location: Norfolk, VA** The **Performance … more
- Elevance Health (Louisville, KY)
- …lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by ... payment as part of consideration for employment. **Pharmacy Internal Auditor ** + Job Family: QLT > Analysis + Type:...processes and processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Tennessee Comptroller of the Treasury (Nashville, TN)
- Auditor : Financial/TennCare This role focuses on examining, analyzing, and reviewing records, financial statements, claims data, and cost reports for providers ... The Comptroller of the Treasury is recruiting for a full-time Auditor : Financial/TennCare position in the Division of State Audit's Tenncare/Medicaid Section.… more
- Humana (Columbus, OH)
- …**Where you Come In** Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If ... and rewards performance, then you should strongly consider the Outpatient Coding Auditor (Surgical Specialty, Outpatient Surgery Coding, E&M and APC) - PPI Coding… more
- ManpowerGroup (Rancho Cucamonga, CA)
- …of the Provider Claims Resolution & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit and recovery of claims overpayments ... **Title: Auditor - Provider Recovery** **Location:** **Rancho Cucamonga, CA...and third-party liability. **Responsibilities:** **Qualification:** + Four (4) years claims processing experience including Medicare and Med-Cal + Two… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) ... audit program. The position provides oversight and maintenance of a high- quality , effective, best practices coding, billing, and reimbursement audit compliance… more
- Oak Orchard Health (Brockport, NY)
- Healthcare Compliance Auditor Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) * Compliance & Risk Description Do you want to be ... a leading, patient-centered organization where professionals come together to improve access to quality health care for all? At Oak Orchard Health, you can grow your… more
- Rush University Medical Center (Chicago, IL)
- …on bonus! **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... individually or in collaboration with other departments. 13. Track coding quality and documentation improvements to measure ROI, organizational growth and support… more
- Hawaii Pacific Health (Honolulu, HI)
- …experience and training, as well as internal peer equity. **Position** Coding Auditor - Compliance **Category** Quality **Employment Type** Employee **Location** ... and other caregivers serving Hawai'i and the Pacific Region with high quality , compassionate care. Its four medical centers - Kapi'olani, Pali Momi, Straub… more
- Railroad Retirement Board (Chicago, IL)
- …Chicago, Illinois. The primary purpose of this position is to serve as an Auditor who functions as an audit team member on assignments at the headquarters level ... in accounting or auditing courses of appropriate type and quality . This can include up to 6 hours of...certificate as Certified Public Accountant or a Certified Internal Auditor , obtained through written examination; or 3. Completion of… more
- The County of Los Angeles (Los Angeles, CA)
- CONTRACT PROGRAM AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4122689) Apply CONTRACT PROGRAM AUDITOR Salary $77,181.84 - ... centers and related health facilities to ensure that appropriate quality of care is maintained by private agencies with...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Auditor and Educator Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's top-performing ... coders. Serves as a resource to coders, CDI staff, Quality and Case Managers, Decision Support and physician office...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- UCLA Health (Los Angeles, CA)
- …risk-based audits and projects, perform regulatory research, investigations, participate in the claims review process. * Perform Quality Assurance reviews. * ... health system. This ties to our commitment of providing quality care to all patients and maintaining a safe...and fair learning and work environment. As a Professional Auditor and Trainer, you will help further our mission… more
- Highmark Health (Jefferson City, MO)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… more
- National Vision (Duluth, GA)
- …deserves to see their best to live their best. We help people by making quality eye care and eyewear more affordable and accessible. National Vision is one of the ... reality. National Vision is hiring a Managed Care QA Auditor to join our growing team! The role is...data accuracy and systematically records the results of their quality review for the purpose of providing feedback for… more
- Covenant Health Inc. (Knoxville, TN)
- …and/or physician office staff. Serves as a resource to coders, CDI staff, Quality and Case Managers, Decision Support and physician office personnel regarding coding ... to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs… more
- PRGX (Bentonville, AR)
- …Resolution + Takes a systematic and logical approach to problem solving Claim Production & Quality + Produces high- quality claims of all levels of complexity ... using client data to identify errors and recover revenue + Produces claims + Reviews contracts, agreements, paperwork and electronic documents + Builds relationships… more
- Sysco (Medley, FL)
- …and other individualized factors SUMMARY: Implement Food Safety & Quality Assurance (FSQA) raw material audit support/evaluation program and inspection/audit ... Group location. ESSENTIAL DUTIES AND RESPONSIBILITIES: Physically and visually assess quality attributes (ie color, size, defects, mispacks, etc.) of raw materials… more