- Elevance Health (St. Louis, MO)
- …including specialized claims with appropriate guidance from management and peers. The ** Claims Auditor II ** is responsible for audits of high dollar ... issues, where applicable. + Refers overpayment opportunities to Recovery Team. + ** Claims Auditor II ** - all the above, plus: Independently interprets… 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 ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II ** is responsible for identifying issues and/or entities… more
- Elevance Health (Tampa, FL)
- **Clinical Provider Auditor II (CPC)** **Hybrid 1:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II ** is responsible for identifying issues and/or entities… 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 - ... professional auditing standards in a law enforcement agency. OPTION II : Three years of professional auditing experience, with a...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- The County of Los Angeles (Los Angeles, CA)
- …*at the level of the County of Los Angeles class of Contract Program Auditor **; -OR- Option II :Four years' experience auditing and evaluating hospitals, and ... SENIOR CONTRACT PROGRAM AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5040931) Apply SENIOR CONTRACT PROGRAM AUDITOR Salary… more
- Highmark Health (Harrisburg, PA)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... + Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Performs...Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new clinical staff, as needed. +… more
- The County of Los Angeles (Los Angeles, CA)
- ACCOUNTING TECHNICIAN II (Community Programs) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4834452) Apply ACCOUNTING TECHNICIAN II ... Diversion and Reentry seek qualified candidates to fill emergency Accounting Technician II vacancies related to the homelessness crisis. Under the emergency order,… more
- MyFlorida (Tallahassee, FL)
- PROGRAM ANALYST II - 64007506 Date: Oct 30, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 864342 Agency: Department of Health Working Title: PROGRAM ANALYST II - 64007506 Pay Plan: Career Service Position Number: 64007506 Salary:… more
- BD (Becton, Dickinson and Company) (Four Oaks, NC)
- …a **maker of possible** with us. **Job Summary** The Quality Tech II is responsible for managing quality systems, handling nonconforming products, and ensuring ... Ensure compliance with quality systems, including holds, product disposition, intracompany claims , QMS audits, and metric data analysis. + Regulatory Compliance: Act… more
- City of New York (New York, NY)
- …PERMANENT EMPLOYEES IN THE TITLE AND THOSE THAT ARE REACHABLE ON THE MANAGEMENT AUDITOR CIVIL SERVICE LIST ARE ELIGIBLE TO APPLY. CANDIDATES MUST STATE THE TITLE ... - Reviewing CBO's independently audited financial statements. - Conducting reviews of monthly claims for reimbursement submitted by CBOs, as part of the NYC Health… more
- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- The County of Los Angeles (Los Angeles, CA)
- …requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more
- The County of Los Angeles (Los Angeles, CA)
- …and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- CareFirst (Reston, VA)
- …Qualifications** **PURPOSE:** The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits. This role ... and procedures. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Control Testing in various process areas such as entity level controls, claims , enrollment operations, IT general computer, and application related controls, etc.* ... Audit project assistance* Attend operational audit planning meetings* Support Auditor in Charge with testing of operational audit(s)* Participate...Level I - Minimum $18.00 - Maximum $20.00 Levell II - Minimum $21.00 - Maximum $23.00 The salary… more