- Monster (Lakewood, NJ)
- …and compliance standards. This role is essential to maintaining the Company 's reputation for quality, supporting ISO certification, and driving ongoing improvement, ... and consistently in the Company 's manufacturing operations. Job Duties: Performs, or oversees a wide range of Quality Assurance tasks involving a variety of plastic… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor I** **Location :** This role...and post payment and adjudication audits of high dollar claims for limited lines of business, claim types ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… 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...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- TEKsystems (San Bernardino, CA)
- The Collector 1 performs telephone calls and website checks for claim status from insurance companies, government payers, third party payers, worker's compensation ... with the terms and conditions of each contract and/or insurance company policies. Determines if payer needs additional information, identifies barriers, and… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- Prime Therapeutics (San Diego, CA)
- …and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in Southern California) **Job Description** The Onsite Pharmacy Auditor ... pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting… more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Tennessee, Knoxville **Alternate Location(s):** ... ID:** J0925-0302 **Employment Type:** Full Time **Position Description:** The OP Coding Auditor is a member of the CGI Healthcare Compliance, Outpatient Coding Team,… more
- Actalent (West Des Moines, IA)
- …wide variety of claim types, and ensuring compliance with departmental and company policies. Responsibilities + Adjudicate claims to maintain and comply with ... medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to...procedures. + Audit and price a wide variety of claim types. + Identify claims with inaccurate… more
- Elevance Health (Richmond, VA)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- AutoZone, Inc. (Little Rock, AR)
- **Job Description** As a **Sr. Audit Recovery Auditor ** , you will Utilize analytical and forensic email review skills to audit Merchandising negotiations to recover ... 3rd Party vendors to recover less than 10% behind Senior Auditor . Negotiate and communicate flawlessly with Merchandising and Vendors to successfully… more
- ManpowerGroup (Vienna, VA)
- …and death claims to verify accuracy, completeness, and compliance with company policies and industry regulations. + Analyze claims documentation, including ... 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
- Sedgwick (Des Moines, IA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you'll have the ... organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. + Leverage Sedgwick's broad,… more
- MAPFRE Insurance (Webster, MA)
- Internal Auditor (Webster or Boston, MA) Date: Aug 24, 2025 Location: Webster or Boston, MA, US Company : MAPFRE **Who We Are** A dynamic, forward-thinking ... risk mitigation, and continuous process improvement. We are looking for an Auditor to optimize and streamline our audit processes while driving innovation and… 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...Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +… 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
- Insight Global (South Jordan, UT)
- …valid claim identification and documentation (letter writing). Identifies potential claims outside of the concept where additional recoveries may be available. ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their… 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 ... identifying risks. + Develops and modifies internal audit programs to include all company functions. + Communicates with company management as needed during… more
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Elevance Health (Des Moines, IA)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
