- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding ... and communicate Key Performance Indicator(KPI) requirements as determined by the Medical Coding Auditor Manager + Participate in the development of coding and… more
- US Bank (Irving, TX)
- …Standards and Guidelines. + Drafting issues under the supervision of the Senior Auditor , Audit Project Manager . Includes identifying root causes rather than ... Operations business line. Operations support multiple business lines, including claims , disputes, complaints, electronic payments and call center activities. The… more
- Catholic Health Initiatives (Little Rock, AR)
- …all things quality and risk for the value hub. + Through Risk Management/ Auditor Manager , implements a risk adjustment coding department in appropriate Arkansas ... providers to improve documentation and coding practices, for accurate claims submissions and accurate reimbursement. + Continue to work...guidelines for these new processes. + Support the Risk Auditor Manager of closely working with the… more
- Elevance Health (Nashville, TN)
- ** 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
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… 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 (Norfolk, VA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- The County of Los Angeles (Los Angeles, CA)
- LAW ENFORCEMENT AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4668332) Apply LAW ENFORCEMENT AUDITOR Salary $109,807.68 - ... law enforcement operations. This classification acts as a project manager and is distinguished by its role in providing...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- City of New York (New York, NY)
- …daily claims reports and the monthly reports which detail claim associated fees to ensure compliance with contractual obligations, regulatory requirements, and ... requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. 2. Claims Data Validation: Verify the… more
- Elevance Health (San Juan, PR)
- …technology and business operations services for health plans. **Performance Quality Auditor I** **Location:** This role requires associates to be in-office [2] ... be necessary based on company needs. The **Performance Quality Auditor I** , responsible for evaluating the quality of...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… 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 ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… 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 ... Performs other duties as needed. Reports to the Revenue Integrity Manager . Recruiter: Suzie McGuinn || ###@covhlth.com Responsibilities Integrity + Identifies and… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …Boars Head Brand. Complete special projects as assigned by the Sr. QA Manager . Job Description: Essential Duties and Responsibilities + Provide advanced super user ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...able to attend a training course. + Serve Safe Manager Certification or be able to attend a training… more
- Aston Carter (Sioux Falls, SD)
- Job Title: Compliance AuditorJob Description The Compliance Auditor will play a crucial role in supporting compliance leadership by assisting in the creation and ... licensing requirements, conducting internal audits, and performing risk assessments. The auditor will also manage vendor risk processes, recommend policy updates,… more
- Sharp HealthCare (San Diego, CA)
- …*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 ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… 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 ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more
- University of Southern California (Los Angeles, CA)
- …with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure ... AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding...and Athena IDX in a manner to assure clean claims release for billing in a timely manner. Participate… more
- Trane Technologies (Grand Rapids, MI)
- …possible for a sustainable world. Position Description As a Trane quality braze auditor , your main duties are to inspect connections, braze joints, brazing processes ... who accepts this role will begin as a braze auditor and will participate in training to become a...system. . Assist with containment actions from customer warranty claims . . Write report with evidence for each unit… more
- Aramco Services Company (Houston, TX)
- OVERVIEW: This position serves as the in-charge auditor on large, complex and sensitive internal auditing assignments. Audits are directed at reviewing internal ... and governance processes. SCOPE: Under the general direction of the Audit Manager , the incumbent will operate independently and is responsible for planning and… more