- 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
- 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: ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities...perform onsite audits (1-4 times per month) + Evaluate claims and provider documentation for compliance and accuracy +… 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
- 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
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The Quality Control Auditor , objectively, systematically, and continuously assesses, assures monitors, evaluates, and improves the quality of ... for all operational staff including but not limited to enrollments & maintenance, claims adjudication & adjustments, member & provider data integrity in the claim,… more
- Elevance Health (Hanover, MD)
- … 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
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42934BR** **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
- UPMC (Pittsburgh, PA)
- …ICD-10-CM, CPT, and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory Compliance:** ... **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)
- …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
- 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
- Humana (Lincoln, NE)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and… 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
- FlexStaff (Chappaqua, NY)
- …and support proper billing and coding - Audit anesthesia records focusing on quality , completeness, and correctness of claims based on services provided - ... **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY-… more
- UPMC (Pittsburgh, PA)
- …and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post-Audit ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is… more
- Insight Global (South Jordan, UT)
- …systems. This position is responsible for auditing inpatient medical records and generating high- quality recoverable claims for the benefit of our client and ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...management team. Achieves the expected level of accuracy and quality set by the audit for the auditing concept,… more
- Executive Office for US Attorneys and the Office of the US… (Boston, MA)
- …auditing, and understanding complex data, including Centers for Medicare & Medicaid claims data and PPP loan data, and activities of entities and individuals ... Similarly, "accountant" should be interpreted, generally, as "accountant and/or auditor .") OR Combination of education and experience: at least...in accounting or auditing courses of appropriate type and quality . This can include up to 6 hours of… more
- University of Southern California (Los Angeles, CA)
- …with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure ... AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding...and Athena IDX in a manner to assure clean claims release for billing in a timely manner. Participate… more