- 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. ... The Coder CHP aids in coordinating and resolving coding issues with all internal CHP departments and Providers. Oversees the coding training throughout Cox HealthPlans.Education: ▪ Required: High school or Equivalent Preferred; College course-work in Health… 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 ... **What you'll do:** + Conduct entry-level audits of professional and facility claims to ensure coding accuracy and compliance with contractual, coding, payment… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor I, II and Senior** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre and post payment and adjudication audits… more
- Conduent (Warren, MI)
- …part of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor ** **Hybrid | Warren, MI** **Part-Time | Hours Assigned as ... Monday- Friday, 7:00 AM - 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor , you'll play a vital role in the Supplier Claim Activity (SCA) group by… more
- Conduent (Los Angeles, CA)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against our… more
- UCLA Health (Los Angeles, CA)
- …to the 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) for accuracy, appropriate application of benefits, authorization for services, contract… 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: ... net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims processed by Delegated… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...supervision. PRIMARY RESPONSIBILITIES: + Conducts monthly audits of CPHL claims utilizing CPHL guidelines, policies and procedures or any… 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
- New York State Civil Service (Syracuse, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... City Syracuse State NY Zip Code 13202 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR CONTRACT PROGRAM AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5040931) Apply SENIOR CONTRACT PROGRAM AUDITOR Salary ... individuals to fill the position of Senior Contract Program Auditor . To view classification standards for the position,Click here...steps to view correspondence, and we will not consider claims of missing notices to be a valid reason… more
- MAPFRE Insurance (Webster, MA)
- Internal Auditor (Webster or Boston, MA) Date: Oct 21, 2025 Location: Webster or Boston, MA, US Company: MAPFRE **Who We Are** A dynamic, forward-thinking ... risk mitigation, and continuous process improvement. We are looking for an Auditor to optimize and streamline our audit processes while driving innovation and… 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 - ... No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… 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
- Sedgwick (Buffalo, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… 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)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
- Sedgwick (Indianapolis, IN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Internal auditor **PRIMARY PURPOSE OF THE ROLE:** To perform internal audit procedures under ... accounting field strongly preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems Auditor (CISA)… 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
- Elevance Health (Hanover, MD)
- **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
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