- LE Cox Medical Centers (Lake Spring, MO)
- …corporate compliance audits at Cox HealthPlans. This position interprets and analyzes medical records to ensure billing accuracies. Reviews coding on healthcare ... claims in order to reimburse from the health plan...to apply coding guidelines when reviewing documentation in the medical record. ▪ Must have experience with detailed knowledge… 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 ... errors, coding discrepancies, and policy non-compliance. Audits include reviewing medical records, applying clinical and coding knowledge, analyzing provider billing… more
- Elevance Health (St. Louis, MO)
- ** Claims Auditor I, II and Senior** **Location...interprets Medical Policy and Clinical Guidelines. + ** Claims Auditor Senior** - all the above, plus ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...various aspects of the claim including eligibility, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… 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, ... direction and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments.… 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...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… 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 ... 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor , you'll play a vital role...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… 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 ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… 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
- Rising Medical Solutions (Milwaukee, WI)
- …With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, ... needs + Being the best, not the biggest The Role: The Specialty Medical Bill Auditor will maximize savings for clients by accurately analyzing and processing … 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...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
- Elevance Health (Hanover, MD)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
- Elevance Health (Las Vegas, NV)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… 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 (Tampa, FL)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II (CPC)** **Hybrid 1:** This role requires...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- Elevance Health (Hanover, MD)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate… more
- Idaho Division of Human Resources (Boise, ID)
- …fraud, financial crimes or white-collar investigations. + Experience analyzing financial records, claims data, or medical billing. + Proficiency in writing ... Criminal Investigator or Investigative Auditor , OAG, Criminal Law Division Posting Begin Date:...Examiner (CFE), Certified Professional Coder (CPC), or Certified Professional Medical Auditors (CPMA) are highly encouraged to apply. Applications:… 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 ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… more
