- City of Detroit (Detroit, MI)
- Director of Internal Audit ( Auditor Manager 3) Print (https://www.governmentjobs.com/careers/detroit/jobs/newprint/4745404) Apply Director of Internal Audit ( ... Auditor Manager 3) Salary $105,064.00 - $137,796.00...administration and operation of City agencies. Settles all disputed claims in favor of or against the City as… more
- Fallon Health (Worcester, MA)
- …recommendations and management action plans by working under the direction of the Lead Auditor or Audit Manager . + Prepare detailed work papers for each project ... all aspects of audits following departmental standards and procedures. **The Internal Auditor will perform or assist in the following:** + Supports the internal… more
- Commonwealth of Pennsylvania (PA)
- …(CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information ... (CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information… more
- Commonwealth of Pennsylvania (PA)
- …(CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information ... (CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information… more
- Commonwealth of Pennsylvania (PA)
- …(CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information ... (CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information… more
- Ventura County (Ventura, CA)
- …(I), direction (II), or under general direction (Senior), of the Auditor -Controller Accounting Manager , the Accounts Payable Contracts Analyst performs ... CA Job Type Full-Time Regular Job Number 0921AUD-24AE (EO) Department Auditor -Controller Opening Date 12/10/2024 Closing Date Continuous + Description + Benefits… more
- 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
- 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 various...Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT),… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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
- Catholic Health Initiatives (Chattanooga, TN)
- …with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an ... met at the highest level. The Sr Coding Compliance Auditor 's primary focus will be to facilitate and ensure...other portion of time focused on provider communication, and claims denial resolutions. Communicates denial trends to leadership and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… 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
- 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
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Coding Auditor and Educator, Centralized Coding Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is East ... initiative and independent judgment. Reports to the Corporate Coding Manager or CFO of CMG as appropriate. Recruiter: Kathleen...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- Covenant Health Inc. (Knoxville, TN)
- …latitude for initiative and independent judgment. Reports to the Corporate Coding Manager or CFO of CMG as appropriate. Recruiter: Sarah Grey || ###@covhlth.com ... + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure...coding and documentation changes and updates. Works with CDI Manager on annual coding updates. + Serves as a… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours Mercy ... Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors… more
- St. Luke's University Health Network (Allentown, PA)
- …The appeals process may include collaboration with the Claim Editing Manager , Physician, Specialty Coder, AR specialist or Auditor /Educator. Demonstrate the ... a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified...role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding… more
- The Hartford (Lake Mary, FL)
- …be determined. + Facilitate gathering and exchange of information with Claims regarding observed and identified billing issues. + Identify opportunities warranting ... further investigation through discussion with Claims and law firms, properly escalating observations internally as...escalating observations internally as well as to the Regional Manager to whom the region applies. + Drive continued… more