- Monster (Lakewood, NJ)
- …compliance. Investigate product non-conformances, customer complaints, and warranty claims , leading root cause analysis and corrective/preventive actions (CAPA). ... QUALIFICATIONS: Bachelor's degree in Engineering, Quality Management, or a related field ( preferred ). 5+ years of experience in quality assurance or quality control… more
- MAPFRE Insurance (Webster, MA)
- …Certified Internal Auditor (CIA) designation or Certified Information Systems Auditor (CISA) designation preferred + 1-2 years of insurance industry ... Internal Auditor (Webster or Boston, MA) Date: Aug 24,...and continuous process improvement. We are looking for an Auditor to optimize and streamline our audit processes while… more
- Sedgwick (Indianapolis, IN)
- …college or university preferred . Major in accounting field strongly preferred . Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or ... certified Information Systems Auditor (CISA) designation preferred . Experience: Four (4) years of related experience or equivalent combination of education and… 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
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all...liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care delegates. Reviews and… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... work independently **Qualifications** **Qualifications:** + Prior auditing experience is preferred + Knowledge of medical terminology + Knowledge of...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …experience Preferred : Type of Experience Required: 2+ years of claim processing experience with a Medicaid/Medicare Health Plan. Preferred : Experience ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … 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
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …as a Quality Assurance Manager in a manufacturing setting + A Certified Aerospace Auditor certification is preferred + Qualified candidates must be an ASQ ... Certified Manager of Quality/OE, Certified Quality Auditor or a Certified Quality Inspector + Experience with...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Actalent (West Des Moines, IA)
- …understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with client ... Nurse Auditor Job Description This role requires a thorough...claims , auditing and pricing a wide variety of claim types, and ensuring compliance with departmental and company… 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...Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims … 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
- Sedgwick (Des Moines, IA)
- …Carrier, Broker, or TPA. + Background in property, liability, and/or CAT claims preferred . + AIC and AIS professional insurance designations or ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you'll have the… more
- Henry Ford Health System (Troy, MI)
- …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Auditor must have a comprehensive understanding of medical terminology, coding, charge ... entry, and healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, coding, billing… more
- HUB International (Chicago, IL)
- …success in mergers and acquisitions. **ABOUT THE ROLE** **Summary:** The PBM Auditor is responsible for conducting comprehensive audits of Pharmacy Benefit Managers ... (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data analysis, contract… more
- BD (Becton, Dickinson and Company) (Four Oaks, NC)
- …Industry-recognized certification in a quality system element (eg, ASQ Certified Quality Auditor ) is preferred . **Knowledge and Skills** + Self-motivated and ... Ensure compliance with quality systems, including holds, product disposition, intracompany claims , QMS audits, and metric data analysis. + Regulatory Compliance: Act… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out of… 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
- Montana State University (Bozeman, MT)
- …Sr. Associate Registrar Email: ###@montana.edu (###@montana.edu) Phone: ### Classification Title Auditor II Working Title Enrollment and Registration Auditor ... business correspondence and general office materials accurately and professionally. Preferred Qualifications - Experience, Education, Knowledge & Skills + General… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate ... Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is crucial in maintaining the integrity of our… more
