- LE Cox Medical Centers (Lake Spring, MO)
- …and analyzes medical records to ensure billing accuracies. Reviews coding on healthcare claims in order to reimburse from the health plan to the billing provider. ... throughout Cox HealthPlans.Education: ▪ Required: High school or Equivalent Preferred ; College course-work in Health Information Management or Technology.… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . As a **Payment Integrity Auditor I** , you will support the overall objectives of the ... Integrity office. This role is responsible for conducting pre-payment and post-payment claim audits to identify improper payments due to billing errors, coding… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …a training course. + SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality - Certified HACCP ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...Auditor , Certified Quality Auditor , Certified Supplier Quality… 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: Oct 21,...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, II and Senior**...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... 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)
- Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… 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
- Commonwealth of Pennsylvania (PA)
- Auditor 1, Southeast Region Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5121668) Apply Auditor 1, Southeast Region Salary $51,971.00 - ... Permanent Full-time Job Number N-2025-35727 Department Department of the Auditor General Division AU Bur Mun Pnsn Aud Opening...You must be able to perform essential job functions. Preferred Qualifications (not required): + One or more of… more
- Elevance Health (Hanover, MD)
- …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
- State of Massachusetts (Boston, MA)
- …General of the Commonwealth, who is appointed by the Governor, Attorney General and Auditor . MGL c. 12A, | 2. The OIG is organized into three bureaus: Specialty ... enforcement state and federal prosecutors. AOI may be investigating claims of public corruption or other wrongdoing in a...appropriate agency if it falls outside our jurisdiction. *Senior Auditor : Position Overview** * The Senior Auditor … 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 (Las Vegas, NV)
- **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, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… 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
- Elevance Health (MD)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Location: Must be located in Maryland.** This field-based role enables ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + ... The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...Performs special audits for specific issues within facility Inpatient claims . + Acts as the Liaison for coding issues… more
- Sharp HealthCare (San Diego, CA)
- …*This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance ... the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. ** Preferred Qualifications** + Other : Strong background in in ICD-10-CM/PCS coding,… more
- Humana (Oklahoma City, OK)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and… more
