- Conduent, Inc. (Dallas, TX)
- Job Description Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent ... pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against our… more
- Aquent (Los Angeles, CA)
- …real impact on healthcare accessibility and affordability as a Financial Compliance Auditor with a mission-driven organization partnered with Aquent. You will play a ... in ensuring the financial integrity and regulatory compliance of healthcare claims , directly contributing to the organization's mission of providing accessible and… more
- North American Partners in Anesthesia (NAPA) (Melville, NY)
- …and electronic medical records. Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process. Proficient ... Savings Accounts 401(k) Leadership and professional development opportunities The Auditor , Revenue Optimization is responsible for conducting audits and reviewing… more
- City of New York (New York, NY)
- …relating to cost allocation. The Finance Office is recruiting for one (1) Management Auditor II to function as an Administrative Claims Preparer who will: - ... Job Description APPLICANTS MUST BE PERMANENT IN THE MANAGEMENT AUDITOR CIVIL SERVICE TITLE, OR BE PERMANENT IN A...COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE Bureau of Claims and Reimbursement (BCR) is responsible for the daily… more
- Novant Health Urgent Cares LLC (Columbia, SC)
- Title: Certified Coding Specialist - Auditor Location: Novant Health Urgent Cares (Columbia, SC) Status: Full-Time Who Are We? Part of the Novant Health family based ... NHUC is currently seeking a Certified Coding Specialist and Auditor to join our Novant Health Urgent Cares Team....data and reports to management related to coding and claims for Doctors Care patient encounters. The Specialist educates… more
- SSA Marine (Seattle, WA)
- …Prepares general ledger and Intercompany reporting. Prepares month-end packages for claims managers and executives Responsible for balancing and reporting amounts ... annual audited financial statements, including preparing audit schedules and responding to auditor requests. Responds to users within the Origami system to the… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... possibility of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief Administrative Officer. This position… more
- Prime Therapeutics (Denver, CO)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims ... is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance,...and accurate documentation receipt and review + Analyze pharmacy claims to identify those at the highest risk for… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... audits on behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical knowledge and regulatory expertise to… 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 ... pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against our… more
- UCLA Health (Los Angeles, CA)
- …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, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123 **Job Locations**… 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
- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...supervision. PRIMARY RESPONSIBILITIES: + Conducts monthly audits of CPHL claims utilizing CPHL guidelines, policies and procedures or any… more
- NTT DATA North America (Decatur, IL)
- …Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and ... including pre-determinations and retrospective reviews. + Review submissions by the Claims Department to determine appropriateness of services through established UM… more
- Amergis (Los Angeles, CA)
- Salary: $50 / Hour Must Haves: + Primary Responsibility: OP Claim Edits - Must have extensive experience in this area + Audit Hospital Based Same Day Surgery with ... Observation Cases (maybe some ED) + Educating Coders + Trauma I & Teaching Hospital Experience (REQUIRED) + 2+ years of recent Auditing Experience + 3+ years of Coding Experience + EPIC & 3M 360 (REQUIRED) + AHIMA or AAPC (REQUIRED) + FLU SHOT AND TB… more
- Insight Global (Los Angeles, CA)
- Job Description Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in the country. This person will be ... responsible for for conducting audits of claims processed by medical groups and health plans contracted...(eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating… more
- UC Health (Cincinnati, OH)
- …an inclusive, equitable and diverse place of employment. The Charge Master Auditor is responsible for executing charge related audits. They assist in evaluating ... compliance related services that resolve charging discrepancies and provide charging related outreach education to clinical departments on charging processes and procedures. Instrumental in working Infusion related edits and providing education to our Infusion… more
- ManpowerGroup (New York, NY)
- Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to join our team. The successful candidate will be responsible for ... compliance with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify… more
- Humana (Indianapolis, IN)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... established guidelines/procedures. **Where you come in** The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates… more
