- LA Care Health Plan (Los Angeles, CA)
- …in a Health Plan environment. At least 3 years experience as a claims auditor /analyst. Prior experience working with Provider Dispute Resolution (PDR) , ... Claims Quality Auditor II Job Category:... Claims Quality Auditor II Job Category: Claims Department:... regulations and company policies. Responsible for High Dollar Claim review of 125K, current knowledge of First Pass… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, September 9, 2024 Centers Plan for Healthy Living's goal is to create the ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Claims Quality Review Auditor is HYBRID position accountable for auditing various claims to ensure quality and accuracy to related ... in claims payments with other departments. + Audits claims data to calculate claim adjudicator and system accuracy, and completes statistical reports on… more
- Medical Mutual of Ohio (OH)
- …DRG,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** **Clinical Auditor ** + **Audits outpatient, inpatient and professional claims ... with payment recovery staff.** + **Performs other duties as assigned.** **Sr Clinical Auditor ** + **Audits outpatient, inpatient and professional claims from a… more
- Commonwealth of Pennsylvania (PA)
- Revenue Tax Auditor Trainee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4645413) Apply Revenue Tax Auditor Trainee Salary $55,550.00 - ... Office of the Bureau of Audits is seeking Tax Auditor Trainees with a keen eye for detail who...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Commonwealth of Pennsylvania (PA)
- Auditor 1 Au - Northeast Region Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4666563) Apply Auditor 1 Au - Northeast Region Salary ... Permanent Full-time Job Number N-2024-94566 Department Department of the Auditor General Division AU DC & RO Div Opening...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Crawford & Company (Fresno, CA)
- Excellence In Everything We Touch Position Summary + Looking for California State Auditor for our CA Workers Compensation Claims Division! + Candidate must have ... experience as CA Claims Adjuster/Examiner! + CA Designation is not a requirement!...and PAR auditing and preparation including ongoing auditing of claim files in preparation for the State's Division of… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Labor, Department of Title Auditor 1/ Auditor Trainee 1/2 - Albany (NY HELPS) Occupational Category Financial, Accounting, Auditing Salary Grade ... 12 City Albany State NY Zip Code 12226 Minimum Qualifications Minimum Qualifications: Auditor Trainee 1:A bachelor's degree in accounting, auditing, or taxation or a… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title Auditor 1/ Auditor Trainee 1/ Auditor Trainee 2 (NY HELPS) Occupational Category ... for appointment through NYS HELPS, you must meet the following minimum qualifications: AUDITOR TRAINEE 1:1. Possess a bachelor's degree in accounting, auditing, or… 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) Occupational Category ... Civil Service Law, Rules and Regulations.Special Minimum Qualifications for transfer to Auditor 1 (Tax):A bachelor's degree including or supplemented by 24 semester… more
- Elevance Health (Indianapolis, IN)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG (DIAGNOSTIC RELATED GROUP) CODING AUDITOR ** **Location** : This position will work a...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- Dignity Health (Phoenix, AZ)
- …Under the supervision of the Business Office Leadership, the Revenue Cycle Auditor role is responsible for monitoring the quality of work performed within ... solid understanding of accounts receivable and your role as a Revenue Cycle Auditor : *Payor Rules & Regulations *Understanding contract language *CCI Coding Issues *… more
- Henry Ford Health System (Troy, MI)
- Reporting to the Manager, Revenue Integrity, the Revenue Integrity (RI) Auditor must have a comprehensive understanding of medical terminology, coding, charge entry, ... and revenue cycle processes. The RI Auditor provides support for timely, accurate and inclusive charge...professional), related medical terminology, use of medical records, billing claim forms, and federal and state regulations related to… more
- Nevada County (Nevada City, CA)
- Senior Accountant- Auditor -Limited-Term * * * $3,000 HIRING BONUS * * * Print (https://www.governmentjobs.com/careers/mynevadacounty/jobs/newprint/4426196) Apply ... Senior Accountant- Auditor -Limited-Term * * * $3,000 HIRING BONUS * *...implementation of new GASB pronouncements + Prepare and file claims and reports with various governmental regulatory agencies The… more
- Fallon Health (Worcester, MA)
- …a key role in auditing risks identified in the organization. The Senior Internal Auditor plays a key role in implementing the annual audit plan. The Senior Internal ... Auditor conducts audits and related projects (financial, operational, and...as special requests. This could include the completion of claims , operational, financial and compliance audits, as well as,… more
- SSM Health (St. Louis, MO)
- …Enhances net revenue by splitting charges that should be presented on separate claims to capture entitled revenue. + Improves claim submissions by reviewing, ... MO-SSM Health Mission Hill **Worker Type:** Regular **Job Highlights:** RN-Clinical Auditor Manager, Care Transformation - Case Management and Social Work 7… more
- Elevance Health (Indianapolis, IN)
- **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/52416/other-jobs-matching/location-only) Hot ... Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL...more of the following: . Audit experience in medical claims and/or claims data. . Certification as… more
- Quality Technology Services, LLC (Atlanta, GA)
- …opportunity to work closely with QTS Executive and Operations leadership. The Senior Auditor is based at QTS's headquarter in Overland Park, KS, with opportunities ... the data center or similar industry. + Attainment of Certified Internal Auditor (CIA), Certified Public Accountant (CPA), and/or Certified Information Systems … more
- TEKsystems (Palm Desert, CA)
- …to DOHC and AZPC (and/or minimize incorrect/inappropriate expenditures) as a result of Claims activities, including but not limited to refund of payments made in ... with HP. + Review CMS Hospice report and recover claims leakage. + Manage TPL and WC recovery vendor...recovery. + Manage DOHC insured services recoveries. + Identify claim leakage for retro terms and recover from vendor/providers… more
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