- Aquent (Los Angeles, CA)
- …As a key member of the Financial Compliance team, you will conduct audits of claims processed by medical groups and health plans. Your meticulous attention to ... difference in the healthcare landscape. What You'll Do: Perform comprehensive audits of claims processed by medical groups and health plans, ensuring compliance… more
- 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 ... 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
- North American Partners in Anesthesia (NAPA) (Melville, NY)
- …employment. Extensive knowledge of medical billing software and electronic medical records. Well-rounded knowledge of CMS requirements claims processing, ... Melville,NY - USA Position Requirements RESPONSIBILITIES Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in… 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 ... therapy facilities across South Carolina. Our Columbia-based headquarters delivers non- medical management and administrative services to support these locations. For… 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, ... needed. Follows established guidelines/procedures. **Where you come in** The Medical Coding Auditor confirms correct CPT coding...+ Experience with SRO, eHub + Experience with the Claims Life Cycle + Experience in Select Coder, 3M… more
- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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 ... of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief...nature of the role offered. Company benefits may include medical , dental, and vision insurance, flexible spending or 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 (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… 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
- WTW (Chicago, IL)
- …PPO, Indemnity and Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical , dental, mental health and ... **Description** As a Lead Auditor you will apply your audit, project management...will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report.… more
- Insight Global (Los Angeles, CA)
- …systems in the country. This person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, ... quarterly reporting (eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating inclusive environments… 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 ... process which includes initiating Case Management, requesting Pre-Certification, submitting Medical Reviews, and Independent Dispute Resolution. The successful candidate(s)… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- …and experience + Certified Professional/ Medical Coder or Certified Professional Medical Auditor desired Experience- + Minimum three years of experience ... Billing Auditor for Shared Services Fully Remote * Rochester,...medical billing and collections including follow-up on unpaid claims , researching insurance claims issues, and appealing… more
- ManpowerGroup (Vienna, VA)
- …and compliance with company policies and industry regulations. + Analyze claims documentation, including medical records, death certificates, policy terms, ... 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
- 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
- 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
- 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...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all aspects of planning, execution, reporting and corrective… more
- Humana (Montgomery, AL)
- …Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, ... materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from … more
