- 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 ... government clients with complex health care reimbursement and provider compliance issues, operate 21 offices and have over 900 associates nationwide. At Myers and… more
- Los Angeles Metro (Los Angeles, CA)
- …2400216 -1 Cabinet: PROGRAM MANAGEMENT Cost Center: 8110 - QUALITY ASSURANCE/ COMPLIANCE Opening Date: 02/19/2025 Closing Date: Continuous FLSA: Exempt Bargaining ... meeting contractual and industry requirements and that work is performed in compliance with Project Quality Program procedures and requirements. This position will… more
- Elara Caring (Fort Worth, TX)
- …Time, in the Right Place. **Job Description:** **REMOTE POSITION** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, ... Care Services (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and...billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited… 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 ... They work to improve documentation quality, identify coding discrepancies, and ensure compliance with regulations as well as supporting SJH, CNY AIM and Trinity… more
- Insight Global (Los Angeles, CA)
- Job Description Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in the country. This person will be ... health plans contracted with LA Care, focusing on regulatory and contractual compliance across Medi-Cal, Medicare , Covered California, and PASC-SEIU programs.… 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)
- …services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer ... work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty… more
- Covenant Health Inc. (Knoxville, TN)
- …research and analysis of CPT coding, modifiers and billing processes to ensure compliance with Medicare , Medicaid guidelines and other insurance payors and to ... Overview Inpatient Coding Auditor and Educator, Centralized Coding Full-Time, 80 Hours...office accounts. Work involves leading or conducting coding and compliance audit projects for Covenant Health entities as they… more
- LA Care Health Plan (Los Angeles, CA)
- …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
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, and… more
- AdventHealth (Altamonte Springs, FL)
- …to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well ... you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding… more
- Nuvance Health (Pembroke Pines, FL)
- …* Lead educational sessions for coders based on audit findings to reinforce compliance with CMS, Medicare , state/federal regulations, and internal policies. * ... TN, TX, and VA. *Job Title: Senior Professional Facility Auditor * *Company: Nuvance Health* *Department: Facility Charging and Coding*...Stay current with CMS, NGS Medicare , AAPC, and OIG updates, bulletins, and … more
- 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
- 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...funds through contracts with DHHS. + Complete financial and/or compliance audits for conformance to established laws, rules, regulations… 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 ... for the A&G department to reduce the risk of non- compliance with appeals and grievance requirements. These can include,...leads to discuss issues and trends identified. The A&G auditor will lead these meetings to discuss trends identified… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Charge Integrity Auditor performs detailed chart to bill audits of inpatient or outpatient medical accounts, comparing the medical ... documented charging practices across the Nuvance Health System. The Charge Integrity Auditor coordinates and reports audits savings or losses for the facilities and… more
- Baystate Health (Springfield, MA)
- …documentation for professional billing to ensure it meets the AMA and CMS ( Medicare ) guidelines for the services billed, reviewing and validating billed charges and ... interacts with employees at all levels. The incumbent has an understanding of compliance audit concepts. This includes but is not limited to relaying confidential… 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
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor . You will review claims (paid, pending, and denied)...services, contract interpretation, Division of Financial Responsibility (DOFR), and application/ compliance with policies and procedures. You will: + Research… more
