- University Health (San Antonio, TX)
- …end-to-end reviews of clinical documentation, coding assignments, charge capture, and claim submissions, ensuring that coding is accurate, complete, and supported by ... medical record. By evaluating operational and revenue cycle activities, the auditor identifies compliance risks, internal control deficiencies, and potential areas… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …be able to attend a training course. + SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...- Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality… more
- Prime Therapeutics (Richmond, VA)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims ... analysis of large datasets and audit findings to detect high-risk pharmacy claims , identify billing irregularities, and uncover patters of non-compliance or systemic… more
- McKinstry (Spokane, WA)
- …preferred. + Lean Belt Certification preferred. + SO 9001:2015 Lead Auditor certification . + Working knowledge and understanding of the ISO 9001:2015 ... continuous improvement projects to reduce defects, rework, and warranty claims , using production quality data to identify and prioritize...Standard and its application. + ASQ Certification . + USACE CQM-C. + OSHA-10 or OSHA-30 … more
- Elevance Health (Roanoke, VA)
- …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 (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... Make an Extraordinary Impact.** **Title** : Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG) **Virtual: ** _ _ This role… more
- US Pacific Fleet (San Diego, CA)
- …You will be required to obtain and maintain a current ISO 9000:2008 Internal Auditor certification . + You will be required to wear personal protective equipment ... when selecting individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit supporting documentation… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. The work authorization is not specified and the salary ... is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ... compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require...Bachelor's Degree in relevant field preferred + Inpatient coding certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS,… more
- Sharp HealthCare (San Diego, CA)
- …provides certificate; Other; Certified Health Care Compliance (CHC) - Compliance Certification Board **Hours** **:** **Shift Start Time:** Variable **Shift End ... *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… more
- Insight Global (Houston, TX)
- Job Description A large hospital system in Houston, TX is seeking a Hospital Auditor to join their Profee team. The Hospitalist Auditor is responsible for ... and identifies opportunities for improvement. In addition to auditing, the auditor will provide targeted education to hospitalist providers to enhance documentation… more
- Idaho Division of Human Resources (Boise, ID)
- Criminal Investigator or Investigative Auditor , OAG, Criminal Law Division Posting Begin Date: 2025/10/22 Category: Criminology Sub Category: Investigative Work ... Hourly Description State of Idaho Opportunity Criminal Investigator or Investigative Auditor , Criminal Law Division, Office of the Attorney General Closing Date:… 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 ... to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs… more
- Highmark Health (Harrisburg, PA)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... as assigned. **QUALIFICATIONS:** Minimum + High school diploma / GED + Certification from American Academy of Professional Coders (AAPC) or American Health… more
- Ontario ARC (Canandaigua, NY)
- …USA | Hourly | 21.60-23.00 per hour | Full Time The Arc Ontario Internal Auditor - Programs Salary: $21.60 - $23.00 Position Overview: We're looking for an Internal ... Auditor to join our team and help ensure our...and run efficiently. In this role, you'll audit billing claims , review Individual Service Plans, conduct site visits, and… more
- Jack Henry & Associates (Birmingham, AL)
- IT Internal Auditor (Early-career level) General information Press space or enter keys to toggle section visibility JobID 16512 Position Level Individual Contributor ... love to meet you. We are seeking an IT auditor to assist with our controls testing. This individual...nice for you to have: + A relevant professional certification (CISA, CISSP, CFE, CISM, CRISC, CGEIT, CIA, PMP,… more
- Healthfirst (NY)
- …provider claims , pre-payments and post-payments including high-dollar and specialized claims across multiple lines of business, claim types and products.** ... to ensure the quality of the network.** + **Review and investigate claims and encounters for medical, facility, pharmacy, dental and vision services including… more
- International (Lisle, IL)
- …Overview International is seeking a detail-oriented and motivated Staff Internal Auditor to support the execution of financial, operational, compliance, and ... frameworks. + Professional certifications (CPA, CIA, CISA) or progress toward certification preferred, but not required. + Strong analytical, problem-solving, and… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program for ... medical record documentation for completeness and accuracy to support billed claims . + Generate provider reports through billing software. + Coordinates, schedules,… more
- Covenant Health Inc. (Knoxville, TN)
- …to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs ... to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority. Minimum Experience: Three (3) to five… more
