- UCLA Health (Los Angeles, CA)
- …career 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,...maintain statistical data consistent + Maintain departmental production and quality standards Salary Range: $31.51 - $62.64 HourlyQualifications We're… more
- Elevance Health (Boston, MA)
- ** Claims Auditor I, II and Senior** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training ... considered for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre and post payment and… more
- US Tech Solutions (Whittier, CA)
- …: Day** **Next Start date: Immediately** **Contract length: 3 months** **POSITION SUMMARY** The Claims Auditor assists in the Claims Department by analyzing ... procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. **SPECIFIC SKILLS NEEDED** Knowledge… more
- Cedars-Sinai (Los Angeles, CA)
- …fuels innovation. **Req ID** : 13340 **Working Title** : Outpatient Surgical and Claims Edit Auditor **Department** : CSRC Coding Audit **Business Entity** : ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We also were...will I be doing in this role?** The Coding Auditor works under the general direction of the Coding… more
- Molina Healthcare (Syracuse, NY)
- … department initiatives to improve overall claims function efficiency. + Meets claims audit department quality and production standards. + Completes basic ... JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste,… 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...keep up to date with departmental changes in conducting quality reviews. + Ensure the consistent use of current… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part of the ... and revises better best practice within the department. The Clinical Auditor /Analyst Intermediate creates, maintains and analyzes auditing reports related to their… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- … Certification preferred (ie American Society for Quality - Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality ... BH Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
- Trane Technologies (Grand Rapids, MI)
- …challenge what's possible for a sustainable world. Position Description As a Trane quality braze auditor , your main duties are to inspect connections, braze ... write audit and/or inspection reports and assessments, and develop quality control monitoring protocols. The person who accepts this...who accepts this role will begin as a braze auditor and will participate in training to become a… more
- Humana (Columbus, OH)
- …evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Elevance Health (Chicago, IL)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Chicago, IL)
- … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- WTW (Houston, TX)
- **Description** As a Medical Claim Field Auditor , you will apply your medical claims audit, project management and claim processing and auditing experience to ... will serve as a team member on audits, evaluate claims for accuracy and identify potential errors and issues....to improve work processes and methods in pursuit of quality output and service delivery + Role will be… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare… more
- Elevance Health (Chicago, IL)
- …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… 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 ... + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as needed. **QUALIFICATIONS** Education & Licensing: Bachelor's… more
- AmeriHealth Caritas (Philadelphia, PA)
- …audit process and communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case is migrated appropriately. ... post-implementation review is completed as the policy outlines. The auditor will be expected to build/run complex queries to...will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all… 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 ... audit program. The position provides oversight and maintenance of a high- quality , effective, best practices coding, billing, and reimbursement audit compliance… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more