- LA Care Health Plan (Los Angeles, CA)
- …remain current on all enhancements and updates to claims regulations and company policies. Responsible for High Dollar Claim review of 125K, current ... a Health Plan environment. At least 3 years experience as a claims auditor /analyst. Prior experience working with Provider Dispute Resolution (PDR) , third party… 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
- 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
- Elevance Health (Indianapolis, IN)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG (DIAGNOSTIC RELATED GROUP) CODING AUDITOR ** **Location** : This position will work a...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… 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 ... auditing risks identified in the organization. The Senior Internal Auditor plays a key role in implementing the annual...as special requests. This could include the completion of claims , operational, financial and compliance audits, as well as,… 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
- 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
- Elevance Health (Columbus, OH)
- **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Sherman Associates, Inc. (Duluth, MN)
- …This is a Sherman Associates owned Marriott International, Inc 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
- 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, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Sedgwick (Knoxville, TN)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Internal Auditor - IT **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?** We are looking for enthusiastic candidates who… more
- Robert Half Management Resources (Los Angeles, CA)
- Description We are in search of a meticulous Sr. Auditor to join our healthcare team in Los Angeles, California. The role involves auditing various aspects of our ... high dollar amount defense audits of patient medical records with insurance company representatives to verify documentation to support hospital charges. * Validate… 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
- 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
- Alphabroder (Lewisberry, PA)
- …+ Process customer returns by sorting/inspecting/identifying product and updating items/quantities on claims in IRMS. Determine if claim is complete. Close/post ... update customer returns in FDM4. Determine if a new claim must be entered or if it is necessary...claims . + Adhere to established safety regulations and company policies/procedures. + Serve as a member of the… more
- Alluvionic (Arlington, VA)
- …next level! Job Summary Alluvionic is seeking aa Federal Travel Regulation (FTR) Auditor who will ensure that travel expenses and reimbursements within the United ... As Needed *This is an onsite position.* Audit Travel Claims : + Review and audit federal employee travel expense...Long-term and short-term disability insurance (paid fully by the company ) + 25k employer paid AD&D & life insurance… more
- Elevance Health (Columbus, OH)
- …each way of a relevant Elevance Health location. The **Performance Quality Auditor lll** is responsible evaluating the quality of services and interactions provided ... Included are processes related to enrollment and billing and claims processing, as well as customer service written and...a number of legitimate, non-discriminatory factors set by the Company . The Company is fully committed to… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Auditor and Educator Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing ... ###@covhlth.com || ### Responsibilities Coding Audits/Education + Identifies and evaluates company risk areas and provides coding auditing procedures related to… more