- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . The **Medical Coding Auditor ** plays a crucial role in ensuring the accuracy and compliance ... leveraging a deep understanding of ICD-10 and other coding standards, the auditor reviews and researches provider diagnostic coding issues, performs detailed medical… more
- Warner Music Group (New York, NY)
- …the contractually-defined scope) of the audit concerned; + Review and analyze the audit claims submitted by the auditor in question, as well as the relevant ... including, without limitation, tracking audit notifications, reviewing and analyzing the claims contained in the audit reports we receive, making recommendations to… more
- Prysmian (Mckinney, TX)
- …ERP system for updates made to NetSuite periodically through the year + Answer auditor requests with urgency + Communicate Non-Trade AR to accounting or other + ... basis (via excel & outlook) + Provide backup to D & R Specialists for freight claim deposits + Offset CR/DR memos as requested by management or D & R Specialists +… more
- Elevance Health (Boston, MA)
- ** Claims Auditor I, II and Senior**...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… more
- Conduent (Warren, MI)
- …part of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor ** **Hybrid | Warren, MI** **Part-Time | Hours Assigned as ... 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor , you'll play a vital role..., you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier… more
- US Tech Solutions (Whittier, CA)
- …: Day** **Next Start date: Immediately** **Contract length: 3 months** **POSITION SUMMARY** The Claims Auditor assists in the Claims Department by analyzing ... procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system...payment of claims and maintenance of the claims system as necessary. **SPECIFIC SKILLS NEEDED** Knowledge of… more
- UCLA Health (Los Angeles, CA)
- …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, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- Cedars-Sinai (Los Angeles, CA)
- …fuels innovation. **Req ID** : 13340 **Working Title** : Outpatient Surgical and Claims Edit Auditor **Department** : CSRC Coding Audit **Business Entity** : ... will I be doing in this role?** The Coding Auditor works under the general direction of the Coding...the general direction of the Coding Supervisor. A Coding Auditor is responsible for reviewing encounters in either a… 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...results to recommend system or procedural changes to increase claim accuracy and/or identify opportunities for workflow enhancements. +… more
- Molina Healthcare (Syracuse, NY)
- JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste, ... overpayments, and claims processing errors. **Essential Job Duties** + Audits the...errors. **Essential Job Duties** + Audits the adjudication of claims using standard principles, and state-specific regulations to identify… more
- UPMC (Pittsburgh, PA)
- …in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part of the… more
- Commonwealth of Pennsylvania (PA)
- Purchase Card Auditor (Administrative Officer 1) - Bureau of Administrative Services Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5176533) ... Apply Purchase Card Auditor (Administrative Officer 1) - Bureau of Administrative Services...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE MANAGEMENT AUDITOR CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE. IF ... YOU ARE HIRED PROVISIONALLY AS A MANAGEMENT AUDITOR , YOU MUST TAKE AND PASS THE MANAGEMENT ...standard audit procedures examine records and documents that support claims submitted to Medicaid for reimbursement for goods or… more
- New York State Civil Service (Rochester, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (Audit Division) (NY HELPS) Occupational ... City Rochester State NY Zip Code 14604 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- New York State Civil Service (White Plains, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Criminal Investigations ... authority;.Represent CID and advocate disputed cases at BCMS conferences and Small Claims .Hearings; may participate at hearings as a witness for the Department… more
- Elevance Health (Chicago, IL)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Ashburn, VA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables… more
- Humana (Columbus, OH)
- …evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- AmeriHealth Caritas (Philadelphia, PA)
- …audit process and communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case is migrated appropriately. ... post-implementation review is completed as the policy outlines. The auditor will be expected to build/run complex queries to...will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all… more
- MAPFRE Insurance (Webster, MA)
- Internal Auditor (Webster or Boston, MA) Date: Nov 22, 2025 Location: Webster or Boston, MA, US Company: MAPFRE **Who We Are** A dynamic, forward-thinking ... risk mitigation, and continuous process improvement. We are looking for an Auditor to optimize and streamline our audit processes while driving innovation and… more
Related Job Searches:
Auditor,
Claim,
Claim Auditor Certified,
Claim Auditor Company,
Claim Auditor Hours,
Claim Auditor Manager,
Claim Auditor Preferred,
Claim Auditor Shift,
Claim Auditor Support,
Claim Auditor System