- Catholic Health Initiatives (Chattanooga, TN)
- …(AAPC) as a Certified Professional Coder (CPC) required. Professional Medical Auditor Certification (CPMA) (CMAS)- preferred but not required. CRC Certification ... with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an… more
- Sedgwick (Nashville, TN)
- …from an accredited college or university with major in Information Systems preferred . Certified Information Systems Auditor (CISA), Certified Internal Auditor ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Internal Auditor / Hybrid **PRIMARY PURPOSE:** To perform IT internal audit procedures under… 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 various...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ... experience Preferred : Type of Experience Required: 2+ years of claim processing experience with a Medicaid/Medicare Health Plan. Preferred : Experience… more
- Cedars-Sinai (CA)
- …related field of study, preferred . **Req ID** : 7494 **Working Title** : Claims Auditor (Managed Care) - Remote **Department** : MNS Managed Care **Business ... we strive for. **What will you be doing:** The Claims Auditor is responsible for ensuring the...Commercial products. Must be familiar with provider dispute resolution. ( preferred ) Knowledge of claims processing, ICD-10, CPT-4… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Criminal Justice Services, Division of Title Auditor 1/Trainee Occupational Category Other Professional Careers Salary Grade 18 Bargaining Unit ... Albany State NY Zip Code 12210 Duties Description The Auditor 1, SG-18 will be assigned to the Office...performing various test, reviews, reconciliations, and evaluation of accounts, claims , records, and procedures to ensure that reimbursed costs… more
- Rush University Medical Center (Chicago, IL)
- …model to other coding staff. * Strong communication and organizational skills. ** Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) ... a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of...focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action… more
- Elevance Health (Waukesha, WI)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **Location** : This position will work a...Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims … more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- Summary With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/ CDM Analyst is responsible for performing audits of ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising… more
- AmeriHealth Caritas (Philadelphia, PA)
- …+ Bachelor's Degree preferred + Minimum of 1 year of advanced-level claims experience and auditing experience + Minimum of 3 years of system configuration ... communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case...will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising the… more
- Elevance Health (Norfolk, VA)
- **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our ... lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by evaluating the… more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/64128/other-jobs-matching/location-only) Hot ... Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL...with a major in accounting or a related field. Preferred Qualifications: In addition to meeting the minimum qualifications,… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as a Senior Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and billing? ... impact? UPMC Corporate Compliance is seeking a dedicated and detail-oriented **Senior Compliance Auditor ** to join our team! This position will be based out of… more
- Sherman Associates, Inc. (Minneapolis, MN)
- …neighborhood. This is a Sherman Associates owned Marriott franchised location. The Night Auditor is a key member of the Guest Services team responsible for the ... assisting with all aspects of guest services. The Night Auditor is responsible for ensuring to provide the highest...all Retail transactions for the guest + Issues luggage claims and check guest luggage when requested + Manages… more
- Elevance Health (Wallingford, CT)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
- Tennessee Comptroller of the Treasury (Nashville, TN)
- Auditor : Financial/TennCare This role focuses on examining, analyzing, and reviewing records, financial statements, claims data, and cost reports for providers ... The Comptroller of the Treasury is recruiting for a full-time Auditor : Financial/TennCare position in the Division of State Audit's Tenncare/Medicaid Section.… more
- BayCare Health System (Atlanta, GA)
- …7:00 AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. This team member must currently reside in ... _Sign on bonuses available!_ **Responsibilities** + The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related activities… more