- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor ...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer ... to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit...planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health… more
- LA Care Health Plan (Los Angeles, CA)
- …tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA Care. This role works ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance...audit results. Perform claims audits for all medical groups and health plans contracted with… 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
- UCLA Health (Los Angeles, CA)
- …your career in an exciting new direction. You can do all this and more at UCLA Health . The Claims Quality Auditor serves as the primary point of contact for ... or equivalent experience required + Minimum of 4 years medical claims payment experience in an HMO...Microsoft Word and Excel. + Good working knowledge of claims adjudication systems. UCLA Health welcomes all… more
- Conduent (Orlando, FL)
- …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
- Elevance Health (Hanover, MD)
- **Clinical Provider Auditor I** **Supports Payment Integrity & Behavioral Health ** _Location:_ This field-based role enables associates to primarily operate in ... medical -expense spending. A proud member of the Elevance Health family of companies, Carelon Behavioral Health ,...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- Elevance Health (MD)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor Senior** is responsible ... **Clinical Provider Auditor Senior** **Supports Payment Integrity line of business**...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency State Comptroller, Office of the Title Auditor 1, SG-18, Auditor Trainee 2, (Equated to SG-16), Auditor Trainee 1, (Equated to ... various tests, reviews, reconciliations, analyses and evaluations of accounts, claims , records, and procedures.o Assists in ongoing audit/examination strategy and… more
- Mohawk Valley Health System (Utica, NY)
- …(CCS-P), or additional specialty certifications (eg, CPMA (Certified Professional Medical Auditor ). Disclaimer Qualified applicants will receive consideration ... Department: MEDICAL GROUP ADMINISTRATION Job Summary The Medical Group Coding Auditor and Educator is...Core Job Responsibilities + Perform thorough reviews of coded claims , ensuring compliance with ICD-10, CPT, HCPCS, HIPAA, HITECH… more
- Elevance Health (Woburn, MA)
- …considered._ The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Mohawk Valley Health System (Utica, NY)
- …(CCS-P), or additional specialty certifications (eg, CPMA (Certified Professional Medical Auditor ) Disclaimer Qualified applicants will receive consideration ... SUPV CODING AUDITOR & EDUCATOR Department: MEDICAL GROUP...billing, compliance and revenue cycle teams to ensure proper claims submission and resolve coding-related claim rejections and denials.… more
- Elevance Health (Seattle, WA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... and skill development. 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
- Chesapeake Regional Healthcare (Chesapeake, VA)
- … record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and ... inpatient hospitalizations, diagnostic testing, outpatient procedures and services, home health care services, durable medical equipment, rehabilitative… more
- Medical Mutual of Ohio (Brooklyn, OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million ... Ohioans through our high-quality health , life, disability, dental, vision and indemnity plans. We...well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a mutual company means… more
- Covenant Health Inc. (Knoxville, TN)
- …Tennessee as RN with equivalent coding experience. Apply/Share Job Title REV INTEGRITY AUDITOR SR ID 4249133 Facility Covenant Health Corporate Department Name ... Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period,...of training. In person meetings required, as needed Covenant Health Overview: Covenant Health is the region's… more
- Rush University Medical Center (Chicago, IL)
- …and organizational skills. **Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications * ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical ...a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of… more
- Sedgwick (Kansas City, MO)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of our clients for… more
- Addiction Recovery Care (Lexington, KY)
- …provision of care, proper documentation of services, and the billing and coding of claims . The Compliance Auditor assists the VP of Compliance and other ... systems in Kentucky (and beyond!) in addiction treatment, mental health services and improving lives by creating opportunities for...of everything we do! We are hiring a Compliance Auditor for our growing team! The Compliance Auditor… more
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