- Aquent (Los Angeles, CA)
- …Financial Compliance team, you will conduct audits of claims processed by medical groups and health plans. Your meticulous attention to detail and analytical ... What You'll Do: Perform comprehensive audits of claims processed by medical groups and health plans, ensuring compliance with contractual and regulatory… more
- Conduent, Inc. (Dallas, TX)
- Job Description Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...Working For You Perks and rewards designed for you: Health and Welfare Benefits: Our health and… more
- Novant Health Urgent Cares LLC (Columbia, SC)
- Title: Certified Coding Specialist - Auditor Location: Novant Health Urgent Cares (Columbia, SC) Status: Full-Time Who Are We? Part of the Novant Health ... What Are We Looking For? NHUC is currently seeking a Certified Coding Specialist and Auditor to join our Novant Health Urgent Cares Team. The Certified Coding… more
- North American Partners in Anesthesia (NAPA) (Melville, NY)
- …employment. Extensive knowledge of medical billing software and electronic medical records. Well-rounded knowledge of CMS requirements claims processing, ... Melville,NY - USA Position Requirements RESPONSIBILITIES Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in… more
- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- UCLA Health (Los Angeles, CA)
- …Take your 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,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief...medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term… 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...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical...offer perks and rewards designed to support you:** + ** Health & Welfare Benefits:** Comprehensive plans tailored to your… more
- WTW (Chicago, IL)
- …a high level of claims administration knowledge, including experience with medical , dental, mental health and Medicare + Detailed knowledge of ICD-10 ... the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment… more
- Insight Global (Los Angeles, CA)
- …person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, focusing on regulatory ... Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health ...(eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating… more
- NTT DATA North America (Decatur, IL)
- …include medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, ... Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all...and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- …and experience + Certified Professional/ Medical Coder or Certified Professional Medical Auditor desired Experience- + Minimum three years of experience ... medical billing and collections including follow-up on unpaid claims , researching insurance claims issues, and appealing...with generous Paid Time Off, 10 paid holidays, affordable medical , dental, and vision options, Health Savings… more
- Elevance Health (Grand Prairie, TX)
- …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
- Elevance Health (Seattle, WA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… 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 - ... choose among a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death and Dismemberment… more
- Elevance Health (Grand Prairie, TX)
- …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
- Humana (Indianapolis, IN)
- …caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ... where needed. Follows established guidelines/procedures. **Where you come in** The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes,… more
- Elevance Health (Indianapolis, IN)
- …for employment, unless an accommodation is granted as required by law._ The **Provider Auditor ** conducts on-site reviews of medical charts, medical notes, ... **Provider Auditor ** **Location** : Indianapolis, IN **Field:** This field-based...+ Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical… more
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