- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Claims Auditor **Job Description** The Pharmacy Claims Auditor is ... responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting downstream claim … more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... **Responsibilities** **Essential Duties and Responsibilities:** + In accordance with company guidelines, performs random audits, target audits, and audits...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- Conduent (Dallas, TX)
- …in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records ... claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be...are engaged in creating the future - both our company 's and your own. With more than 60,000 associates… more
- Robert Half Accountemps (Los Angeles, CA)
- …near Los Angeles is seeking a detail-oriented and experienced Medical Clinical Trial Claims Auditor . This role involves meticulous oversight and auditing of ... claims related to our clinical trials to ensure compliance...contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. (C)… more
- ManpowerGroup (New York, NY)
- …with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify ... Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to... Claims : Conduct thorough audits of life insurance claims , including verifying claim amounts, beneficiary information,… more
- TEKsystems (Chesapeake, VA)
- …With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/CDM Analyst is responsible for performing audits of itemized ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising… more
- ManpowerGroup (Vienna, VA)
- …and death claims to verify accuracy, completeness, and compliance with company policies and industry regulations. + Analyze claims documentation, including ... Our client, is seeking a Bank and Corporate Owned Life Insurance (BOLI/COLI) Auditor to join their team. As a Bank and Corporate Owned Life Insurance (BOLI/COLI) … more
- Health Advocates Network (Phoenix, AZ)
- Contract **Job # 24538 Charge Auditor ** **Acclivity Healthcare - Your personable, proven partner!** Since 1999, Acclivity Healthcare has served the specialized ... of better talent. **Compensation and Schedule for the Charge Auditor ** Charge Auditor - Full-time, work-from-home, $25-$35...- Work with Audit and Education Specialists to assist claim audits and understanding on missed charges based on… more
- Humana (Columbus, OH)
- …**Where you Come In** Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical...looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers… more
- Elevance Health (Richmond, 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
- Robert Half Accountemps (Los Angeles, CA)
- …for verifying, rectifying, and finalizing edits in the Patient Accounting System or claims editing system. The Chart Auditor will occasionally conduct insurance ... carry out extensive defense audits of patient medical records with insurance company representatives. * Correct charges and coordinate re-bills based on agreed audit… 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...provide the highest level of guest service and that company standards are met and maintained at all times.… 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
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the Senior Internal Auditor offers exposure to many areas of the company and works with our external auditors. The work performed helps to provide assurance ... the Audit, Risk Management & Information Security (ARMIS) team, the Senior Internal Auditor will perform and support audits and assessments related to financial and… more
- ManpowerGroup (Madison, AL)
- Our client, a leading company in the automotive manufacturing industry, is seeking a Parts Logistics Auditor to join their team. As a Parts Logistics Auditor ... logistics, inventory management, and internal controls. **Job Title:** Parts Logistics Auditor **Location:** Remote **Pay Range:** $55 - $70/hour **What's the Job?**… more
- Highmark Health (Harrisburg, PA)
- ** Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Sedgwick (Knoxville, TN)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Internal Auditor **PRIMARY PURPOSE:** To perform IT internal audit procedures under general ... direction and to assist in supporting the Company 's ISO 27001 certification. **ARE YOU AN IDEAL CANDIDATE?**...with major in Information Systems preferred. Certified Information Systems Auditor (CISA), Certified Internal Auditor (CIA), or… more
- NJM Insurance (Trenton, NJ)
- Our Commercial Lines department is seeking a Premium Auditor with strong organizational and time management skills. The auditor will be responsible for ... performing audits of Commercial Lines policies in accordance with company , industry and government rules and regulations in order to establish appropriate… more
- Fallon Health (Worcester, MA)
- **Overview** **About us:** Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in ... all aspects of audits following departmental standards and procedures. **The Internal Auditor will perform or assist in the following:** + Supports the internal… more