- Elevance Health (Mason, OH)
- ** Clinical Provider Auditor II ** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II...or any combination of education and experience, which would provide an equivalent background. + Requires coding certification (CPC,… more
- Elevance Health (Des Moines, IA)
- ** Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II ** is responsible for… more
- Elevance Health (St. Louis, MO)
- **Claims Auditor II ** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... accommodation is granted as required by law._ The **Claims Auditor II ** is responsible for audits of...to Recovery Team. + Independently interprets Medical Policy and Clinical Guidelines. **Minimum Requirements :** + Requires a HS… more
- Highmark Health (Helena, MT)
- …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 ... meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system...+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and… more
- US Tech Solutions (IL)
- …**possible extension)** **Purpose:** + Performs key operational activities across the ** Clinical Documentation** Center for master files through life cycle. + ... Collaborates with **Master File** Owners to support inspection readiness of clinical documentation / master files; may be aligned by Therapeutic Area but expected to… more
- Terumo Medical Corporation (Elkton, MD)
- Quality Engineer II Date: Sep 11, 2025 Req ID: 4925 Location: Elkton, MD, US Company: Terumo Medical Corporation Department: Quality Engineering Operations Terumo ... products, training and education programs that drive clear economic value, better clinical outcomes and improved quality of life for patients. TMC is part… more
- Medtronic (Lafayette, CO)
- …patient care, anytime, anywhere. Through connected solutions seamlessly integrated into clinical practice, we help predict and prevent dangerous and costly ... quality parts, materials, and services, prevent defects, and allows Medtronic to provide customers with the highest quality and reliability products. + Collaborates… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition, to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... solution of problems of organization, program, procedure, budget, or personnel. Option II : Two (2) years of highly responsible administrative or staff experience at… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... program, procedure, budget, or personnel. - OR - Option II : Two (2) years of highly responsible administrative or...Assistant III**, Assistant Hospital Administrator I , Contract Program Auditor , or higher. YouMUSTmeet one of the above… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... control systems. Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the preparation of reports to support… more
- The County of Los Angeles (Los Angeles, CA)
- …of Intermediate Accountant- Auditor , Accountant III or higher. PHYSICAL CLASS II - Light: This class includes administrative and clerical positions requiring a ... in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- Medical Mutual of Ohio (OH)
- …oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, ... (CAHPS) and Health Outcomes Survey (HOS). Supports data capture and reporting of clinical quality of care received by members. Works closely with the Quality team… more
- Dignity Health (Bakersfield, CA)
- …The Delegation Management Specialist I supports the Delegation Management Specialist II along with the Delegation Management Department (DOD) in the management ... management. Will act as a liaison between the contracted provider groups in the delegation management process; to include...close collaboration with various departments within the DHMSO to provide the CAP response in a timely manner to… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more
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