- 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
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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
- Elevance Health (Richmond, VA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- AutoZone, Inc. (Little Rock, AR)
- …unique claim . + Responsible for drafting own correspondence for Manager review. Assist direct report(s) with creating drafts and sending straightforward ... **Job Description** As a **Sr. Audit Recovery Auditor ** , you will Utilize analytical and forensic...communicate flawlessly with Merchandising and Vendors to successfully resolve claims and recover all vendor funding dollars due AutoZone.… 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 - ... law enforcement operations. This classification acts as a project manager and is distinguished by its role in providing...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- City of New York (New York, NY)
- Job Description Only permanent Administrative Management Auditor and Incumbent employees are eligible to apply. DCAS's mission is to make city government work for ... to ACS' Senior leadership, auditees and stakeholders. Responsibilities for the Lead Auditor /Supervisor will include but may not be limited to: - Plan, coordinate… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Manager , Revenue Integrity, the Revenue Integrity Auditor must have a comprehensive understanding of medical terminology, ... charge entry, and healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, coding,… more
- Elevance Health (Hanover, MD)
- **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, ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… 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
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
- …you will assist with special projects as directed by the Senior QA Manager . Job Description: Essential Duties and Responsibilities + Conduct Food Safety and Product ... product specifications, allergen forms, weight and tare information, and other product claims , as applicable. + Maintain accurate supplier information in the QMS… more
- Aramco Services Company (Houston, TX)
- OVERVIEW: This position serves as the in-charge auditor on large, complex and sensitive internal auditing assignments. Audits are directed at reviewing internal ... and governance processes. SCOPE: Under the general direction of the Audit Manager , the incumbent will operate independently and is responsible for planning and… more
- City of New York (New York, NY)
- …30-30 Thomson Ave, LIC, Queens 11101 As the City's primary capital construction project manager , we build many of the civic facilities New Yorkers use every day. We ... 4500 payment requests annually. DDC seeks a Capital Payment Auditor to review and process these payment requisitions. To...(in FMS3); and adjust payment voucher(s) due to liens, claims and assignments. The candidate will use the DDC… more
- The Cigna Group (Bloomfield, CT)
- … claims review and adjustments as directed by Provider Relations Sr. Auditor & Analysis Manager . Proven communication skills. Ability to move quickly ... : Primarily responsible for the department's Daily Trucare report case assignment, claims review and adjustment reporting assistance, and back-up to the department's… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours Mercy ... Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors… more
- 3M (Monroe, NC)
- …for Quality-ASQ certification(s): Certified Quality Engineer (CQE), Certified Quality Auditor (CQA), Certified Manager of Quality/Organizational Excellence ... qualification, measurement system analysis, supplier management, regulatory compliance, and claim substantiation. The hire will also collaborate with manufacturing… more
- St. Luke's University Health Network (Allentown, PA)
- …The appeals process may include collaboration with the Claim Editing Manager , Physician, Specialty Coder, AR specialist or Auditor /Educator. Demonstrate the ... a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified...role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding… more
- DoorDash (Tempe, AZ)
- …injury and property damage claims are required. You will report to the Insurance Claims Manager and work a hybrid schedule at our Tempe, AZ office. During ... The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more
- Defense Microelectronics Activity (Mcclellan, CA)
- …IP Manager , Enablement Manager , MPW Manager , TAPO Share Point Manager , Trusted Auditor , MICP Assessable Unit Manager (AUM), COR or Program ... provide transcripts or other documentation to support your educational claims . All materials must be submitted by the closing...incentive may be authorized if determined by the Hiring Manager to be in the best interest of the… more