• Baystate Health (Springfield, MA)
    …in daily work: C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if applicable. 3) Unit-specific projects: ... to transfer and discharge. Explains and obtains signatures for Medicare forms. Organizes charts for Medical Records, and faxes...the unit. When appropriate, enter data into the PCM auditor at specified times. Replenish and restock unit audit… more
    Upward (07/20/25)
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  • CBIZ, Inc. (Atlanta, GA)
    …health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45 years of experience assisting our ... employees through our Employee Assistance Program Position Overview: The Staff Auditor /Accountant will perform reviews of Medicaid provider cost reports, analyze… more
    Upward (07/19/25)
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  • Los Angeles Metro (Los Angeles, CA)
    …functions Registration as a Professional Engineer preferred Certified Quality Auditor , Certified Manager of Quality, or Certified Quality Engineer preferred ... Benefits : Transportation passes for employees and/or eligible dependents; Medicare ; Tuition reimbursement; credit union membership; SDI; Deferred Compensation Plan;… more
    Upward (06/27/25)
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  • Senior Internal Auditor ( Medicare

    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
    CVS Health (07/03/25)
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  • Auditor 1

    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
    New York State Civil Service (07/18/25)
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  • Risk Adjustment Auditor Educator Fully…

    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
    Trinity Health (07/18/25)
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  • Litigation and Investigations Auditor

    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
    CACI International (07/11/25)
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  • Billing Compliance Auditor (RN)

    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
    Elara Caring (07/09/25)
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  • Customer Solution Center Quality Auditor II

    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
    LA Care Health Plan (07/11/25)
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  • Physician Coding Auditor

    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
    MedKoder (06/12/25)
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  • Inpatient DRG Quality Auditor

    Humana (Montgomery, AL)
    …a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and assigns ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle… more
    Humana (07/25/25)
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  • Quality Auditor /Educator Remote

    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
    AdventHealth (07/10/25)
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  • Staff Auditor I

    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
    State of Maine, Bureau of Human Resources (07/09/25)
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  • Specialty Health Plans Auditor III

    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
    LA Care Health Plan (07/06/25)
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  • Claims and Call Auditor (Call Center QC)

    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
    CHS (06/14/25)
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  • Coding Off Auditor -Edu

    Covenant Health Inc. (Knoxville, TN)
    Overview Inpatient Coding Auditor and Educator, Centralized Coding Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is East ... of CPT coding, modifiers and billing processes to ensure compliance with Medicare , Medicaid guidelines and other insurance payors and to maximize reimbursement. +… more
    Covenant Health Inc. (07/25/25)
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  • Appeals & Grievances QA Auditor

    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
    Point32Health (07/22/25)
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  • Sr Professional Facility Auditor

    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
    Nuvance Health (07/18/25)
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  • Coding Auditor & Educator

    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
    Trinity Health (05/28/25)
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  • Medical Coding Auditor Evaluation…

    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
    Humana (07/24/25)
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