- Solugenix (Los Angeles, CA)
- Financial Compliance Auditor III, Claims Los Angeles, CA (Remote/Hybrid) 3-Month Contract (Possibility of conversion to a permanent position) Job ID 25-09703 ... insurance company, in their search for a Financial Compliance Auditor III, Claims. This is a 3-month contract opportunity...for a variety of complex areas of the Medi-Cal, Medicare , Covered California, and PASC-SEIU benefits and processes. This… 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 ... of experience performing claims audits or claims processing related to Medi-Cal, Medicare , and/or other managed care product lines. Strong knowledge of healthcare… more
- HonorVet Technologies (Albany, NY)
- …current, and valid Navigating various federal and State databases, including Medicare 's enrollment system (PECOS) and other states' licensing verification websites ... Contacting providers via email or phone if information is incomplete or requires further clarification Entering and updating provider information in eMedNY Meeting production and quality standards Additional Skill Level, Experience or Other Requirements:… more
- Optum (San Juan, PR)
- …Coder (CPC) + CPC A Certified Inpatient Coder (CIC) Certified Outpatient Auditor (COC) Certified Professional Medical Auditor (CPMA) Certified Coding Specialist ... Federal and State Statues, Rules and Regulations Knowledge of Medicaid/ Medicare Reimbursement methodologies Working knowledge of the healthcare insurance/managed… more
- SCAN (Long Beach, CA)
- …member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 285,000 members in California, Arizona, Nevada, ... Year-round audit readiness activities Pre-audit deliverables Onsite scheduling and auditor requests Post-audit reviews and deliverables Post validation reviews Audit… more
- CVS Health (Hartford, CT)
- …+ The Sr Analyst, Internal Audit will be a key member of the Internal Audit team and will participate in the execution of internal audits. This role is responsible ... for basic auditing tasks including: developing audit objectives, documenting and evaluating critical controls, implementing audit tests, and communicating with / reporting audit findings to business line management. + CVS Health follows a hybrid work model… more
- New York State Civil Service (Lowville, NY)
- NY HELP Yes Agency People With Developmental Disabilities, Office for Title Auditor 1 Occupational Category Other Professional Careers Salary Grade 18 Bargaining ... State NY Zip Code 13367 Duties Description Under the general direction of an Auditor 2:* performs research on the organization to be audited; * assists in… more
- Trinity Health (Syracuse, NY)
- …if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding and documentation in ... Must have 5 or more years' experience as a risk adjustment auditor and educator and/or clinical documentation improvement specialist with a solid background… more
- CACI International (Latham, NY)
- Litigation and Investigations Auditor Job Category: Finance and Accounting Time Type: Full time Minimum Clearance Required to Start: Public Trust Employee Type: ... litigation and investigative matters. We are seeking a **Litigation and Investigations Auditor ** to support trial and investigative teams with complex audits and… more
- Elara Caring (Fort Worth, TX)
- …the Right Place. **Job Description:** **REMOTE POSITION** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, Hospice, ... (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and billing rules. Areas of...coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited to: (1) conducting… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Quality Auditor II Job Category: Customer Service Department: Even MORE Quality Location: Los Angeles, CA, US, 90017 Position Type: Full ... that purpose. Job Summary The Customer Solution Center Quality Auditor (QA) II is responsible for monitoring and actively...daily error reports, analyze results from Call Center, MRP, Medicare , MRU, Outbound and Outreach, and LA Care Covered… more
- MedKoder (Mandeville, LA)
- …work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty ... and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer guidelines to ensure receipt of… more
- AdventHealth (Altamonte Springs, FL)
- …you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding ... to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor I Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: July 31, 2025 Apply with Linkedin Apply Department of Health ... to its staff. ABOUT THE POSITION: As a Staff Auditor I you will: + Perform professional audit work...grow personally and professionally as you acquire knowledge of Medicare , Medicaid, and Federal grants. REQUIREMENTS: To qualify, you… 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 ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all aspects of planning, execution,...Serves as primary contact and liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... + Knowledge of medical coding systems + Knowledge of Medicaid/ Medicare Guidelines + Knowledge of billing rules and regulations....to thirty (30) pounds. ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** **… more
- Point32Health (MA)
- …Summary** Under the direction of the A&G Manager, the Appeals & Grievances QA Auditor audits the quality of letters and keyed entries from the Grievance and Appeals ... meetings with department leads to discuss issues and trends identified. The A&G auditor will lead these meetings to discuss trends identified through their audits.… more
- Nuvance Health (Pembroke Pines, FL)
- …PA, SC, TN, TX, and VA. *Job Title: Senior Professional Facility Auditor * *Company: Nuvance Health* *Department: Facility Charging and Coding* *Location: Remote* ... Role* Nuvance Health is seeking a detail-oriented and experienced *Senior Professional Facility Auditor * to join our Facility Charging and Coding team. In this role,… more
- Trinity Health (Boise, ID)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Coding Auditor & Educator performs medical record audits including analysis of medical ... and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge… more
- Humana (Indianapolis, IN)
- …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... established guidelines/procedures. **Where you come in** The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates… more
