- 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
- The Cigna Group (Detroit, MI)
- …complete audits to address identified risks and present findings to the Sr Audit Manager . The Staff Auditor may participate in third-party audits and work ... members and work on special projects as needed. The Auditor role will support the Sr. Manager -...informed, objective assessment of the accuracy and legitimacy of claims audited. + Utilize personal knowledge of medications and… more
- Elevance Health (Boston, MA)
- ** 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
- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment,... has working knowledge of the overall aspects of claim processing, both in and outside of Security Health… more
- UPMC (Pittsburgh, PA)
- …(NCD) or Local Coverage Determination (LCD). + Evaluate referrals from Pharmacy Benefit Manager (PBM) by analyzing medical and pharmacy claims and associated ... in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and… more
- Elevance Health (Chicago, IL)
- …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 (Chicago, IL)
- …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
- Humana (Madison, WI)
- …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 (Chicago, IL)
- **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, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… 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
- 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
- Cedars-Sinai (Los Angeles, CA)
- …Best Hospitals. **What you be doing in this role:** The Physician Compliance Auditor is responsible for reviewing and auditing claims , medical records, and ... use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with documentation, coding, and billing.… more
- Elevance Health (Atlanta, GA)
- **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the exception of ... of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you… 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
- Aston Carter (Sioux Falls, SD)
- Job Title: Compliance AuditorJob Description As a Compliance Auditor , you will play a crucial role in supporting the Compliance Leadership team, including the Chief ... Compliance Officer and Compliance Manager , by assisting in the creation and maintenance of...business. Essential Skills + Minimum 2 years in a compliance/ auditor role, preferably within the banking industry. Additional Skills… 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
- State of Indiana (Indianapolis, IN)
- Insurance Regulatory Auditor Date Posted: Dec 11, 2025 Requisition ID: 466900 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with ... loss or harm. Consumers may need assistance with certain claim situations or just help in understanding how their...various reports or gather specific information requested by the Manager , Chief Examiner, or Commissioner. The job description is… more