- LA Care Health Plan (Los Angeles, CA)
- …health plans contracted with LA Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in a timely and ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type:… more
- Elevance Health (Richmond, VA)
- …service written and verbal inquiries. **How you will make an impact:** + Assists higher level auditor / lead on field work as assigned and acts as auditor in ... **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid...in pre and post implementation audits ofpharmacy operational processes, claims processing and payment, member and provider inquiries, enrollment… more
- City of Detroit (Detroit, MI)
- Director of Internal Audit ( Auditor Manager 3) Print (https://www.governmentjobs.com/careers/detroit/jobs/newprint/4745404) Apply Director of Internal Audit ( ... Auditor Manager 3) Salary $105,064.00 - $137,796.00 Annually Location...administration and operation of City agencies. Settles all disputed claims in favor of or against the City as… more
- Elevance Health (Grand Prairie, TX)
- **DRG Coding Auditor (DIAGNOSTIC RELATED GROUP)** _This position will work virtually._ _Alternate locations may be considered._ _The Ideal candidate must live within ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG Coding Auditor ** is responsible for auditing inpatient medical records and generating… more
- AmeriHealth Caritas (Philadelphia, PA)
- …documentation for completeness. Communicate with the configuration analyst, configuration team lead , tester, and requestor as required to ensure the request is ... 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
- Elevance Health (Columbus, GA)
- **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
- Elevance Health (Columbus, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ Alternate locations may be considered. This position will work in a ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Fallon Health (Worcester, MA)
- …identified, recommendations and management action plans by working under the direction of the Lead Auditor or Audit Manager. + Prepare detailed work papers for ... all aspects of audits following departmental standards and procedures. **The Internal Auditor will perform or assist in the following:** + Supports the internal… more
- General Motors (Detroit, MI)
- …Motors policies and procedures against dealership practices, relative to warranty and policy claims for compliance. This Auditor interacts with the Dealer, their ... per week, at minimum. **The Role** The Warranty Dealer Auditor is responsible for reviewing select, high risk Job...two per day) + Determines the compliance of these claims with the rules and policies + Constructs a… more
- Army National Guard Units (Jefferson City, MO)
- …Service Position. This position is an Indefinite with Right to Convert GS-0511-11 AUDITOR (TITLE 5), Position Description Number T5147P01 and is part of the MO ... answers questions. Performs survey work to identify potential operating problems. Prepares lead sheets to identify any potential weaknesses in internal controls that… more
- Lockheed Martin (Bethesda, MD)
- **Description:** Join Lockheed Martin's Corporate Internal Audit \(LMCIA\) team as a Financial Auditor and play a key role in evaluating and improving the company's ... a company culture that empowers employees to think big, lead with a growth mindset, and make the impossible...government finance including CAS, FAR, DFARS, GAGAS, incurred cost claims , and contract and indirect rate closure processes\. Understands… more
- Trinity Health (Columbus, OH)
- …effective working relationship with providers and their billing staff + Performs responsibilities of Claims Auditor as time and work load permit and dictate + ... **Employment Type:** Full time **Shift:** **Description:** Remote position - Seeking Claims processing with Medical Insurance Minimum of 5 years experience in … more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits. This role ... and procedures. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and… more
- Ventura County (Ventura, CA)
- …CA Job Type Full-Time Regular Job Number 0921AUD-24AE (EO) Department Auditor -Controller Opening Date 12/10/2024 Closing Date Continuous + Description + Benefits ... - 12 paid days per year which includes a scheduled floating holiday. THE AUDITOR -CONTROLLER'S OFFICE By State Law, the Auditor -Controller is charged with the… more
- The Cigna Group (Seattle, WA)
- …changes in processing procedures. **Job Description** The Quality Review and Audit Lead Hybrid Auditor is primarily responsible for using analytical skills ... requirements. **ESSENTIAL FUNCTIONS** + Perform efficient and effective network pharmacy claims audits to produce results consistent with departmental policies and… more
- 3M (Maplewood, MN)
- Job Description: Software Systems Lead Collaborate with Innovative 3Mers Around the World Choosing where to start and grow your career has a major impact on your ... You'll Make in this Role As a Software Systems Lead , you will have the opportunity to tap into...such as migrating legacy systems, regional deployments of the Claims module and implementing process improvements for CMP +… more
- Ellis Medicine (Schenectady, NY)
- …will work with both staff and third party insurers to ensure that all claims are billed appropriately and that staff is effectively trained. The manager is expected ... all information, which is required for payment of the claims , will be obtained by staff prior to the...both internal and external + Has the ability to lead meetings that stay on track and move everyone… more
- Ventura County (Ventura, CA)
- …and financial analysis/reporting duties. At the Senior level, may provide lead supervision to lower level professional, technical or clerical staff. DISTINGUISHING ... financial analysis/reporting requirements; positions may also be assigned direct or lead supervisory duties over lower level staff when such assignments are… more
- Warner Music Group (Nashville, TN)
- …the respective WMG label for the audit concerned; + Review and analysis of audit claims submitted by the auditor in question, as well as the relevant provisions ... recordings and record those labels release. **Your role:** This position will lead all aspects of the audit process, including, without limitation, tracking audit… more
- The County of Los Angeles (Los Angeles, CA)
- …system. + Assist in the reconciling of accounts with the Auditor 's abstract. + Compile prescribed financial-statistical data. + Prepare highly standardized ... depreciation and accrued expenses and revenues. + Prepare complex claims for reimbursement. + Perform work which required the...so may result in an incomplete application and may lead to disqualification We will send notifications to the… more