- 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
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor . You will review claims (paid, pending,...+ Computer proficiency with Microsoft Office + Knowledge of claims adjudication systems + Flexibility and adaptability… more
- Cedars-Sinai (Los Angeles, CA)
- …fuels innovation. **Req ID** : 13340 **Working Title** : Outpatient Surgical and Claims Edit Auditor **Department** : CSRC Coding Audit **Business Entity** : ... of the Year. This award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement....will I be doing in this role?** The Coding Auditor works under the general direction of the Coding… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …including basic analysis of identified trends. + Analyzes audit results to recommend system or procedural changes to increase claim accuracy and/or identify ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …methods, or statistics; OR A bachelor's degree plus a Certified Information Systems Auditor (CISA) or Certified Government Audit Professional (CGAP) designation; ... Public Accountant (CPA) license, or designation as a Certified Information Systems Auditor (CISA), Certified Government Audit Professional (CGAP), Certified… more
- New York State Civil Service (White Plains, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (Audit Division) (NY HELPS) Occupational ... White Plains State NY Zip Code 10601 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- New York State Civil Service (White Plains, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Criminal Investigations ... authority;.Represent CID and advocate disputed cases at BCMS conferences and Small Claims .Hearings; may participate at hearings as a witness for the Department… 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...preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + ... The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...related activities and services provided by the BayCare Health System HIM Coding Department. + Interacts directly with coders,… more
- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- New York State Civil Service (Albany, NY)
- …State NY Zip Code 12210 Duties Description Under the general direction of an Information Systems Auditor 2, in the Office of Internal Audit, the Auditor ... NY HELP No Agency Information Technology Services, Office of Title Auditor 1 - 10273 Occupational Category IT Engineering, Sciences Salary Grade 18 Bargaining Unit… more
- Robert Half Finance & Accounting (Kansas City, MO)
- Description We are seeking a skilled Revenue Systems Auditor to lead compliance assurance and auditing functions across Skilled Nursing and Senior Living ... billing and trust account activities. + Diagnose and resolve system issues that affect claim processing and...Diagnose and resolve system issues that affect claim processing and payments, introducing improvements to support workflow… more
- MAPFRE Insurance (Webster, MA)
- …designation, Certified Internal Auditor (CIA) designation or Certified Information Systems Auditor (CISA) designation preferred + 1-2 years of insurance ... Internal Auditor (Webster or Boston, MA) Date: Nov 22,...industry knowledge ( Claims , Underwriting, Insurance Operations, etc.)An understanding of internal audit… more
- Insight Global (South Jordan, UT)
- …MS-DRG, AP-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...an understanding of the MS-DRG, AP-DRG, and APR-DRG payment systems . This position is responsible for auditing inpatient medical… 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
- Elevance Health (Seattle, WA)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Sedgwick (Indianapolis, IN)
- …Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems Auditor (CISA) designation preferred. Experience: Four (4) years of ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Internal Auditor **PRIMARY PURPOSE OF THE ROLE:** To perform internal audit procedures under… more
- Highmark Health (Harrisburg, PA)
- …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
- Sharp HealthCare (San Diego, CA)
- **Facility:** System Services **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified ... remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp...coding or professional E/M coding in the following coding systems : ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. **Preferred… 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 ... in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees,… more