- Nesco Resource (Long Beach, CA)
- …analyzes management reports and takes appropriate action.Performs quality review on claims in compliance with audit requirements, service contract requirements, ... activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ...claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex… more
- MultiPlan (Atlanta, GA)
- …will employ data mining and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. JOB ... to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to ensure medical...mining and coordination of benefits techniques to client paid claims data.3. Evaluate medical claims for coding… more
- MultiPlan (Atlanta, GA)
- …will employ data mining and coordination of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. The ... bright people come to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to ensure medical payments have been… more
- US Tech Solutions, Inc. (Columbia, SC)
- …Research variances, document discrepancies and make appropriate adjustments. 15% Respond to audit letters. Work with other areas including claims , marketing and ... packets and responding to any requests for additional information. Additionally, the claims must be tracked and monitored. Complex analysis is performed and queries… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …with other documentation, coding and billing standards. CEQAs apply standardized audit scoring methodology to evaluate consistency of documentation and coding, and ... standardized audit findings methodology to report audit results....concerns, and make plans for processes/procedures.Assists with submission of charges/ claims during high volume and/or end of month. Assists,… more
- Option Care Health (Chicago, IL)
- …actions. Partners with functional leaders and field teams to coordinate audit and monitoring activities from initiation through completion of corrective action. ... and fraud and abuse. Coordinates with internal stakeholders to identify audit objectives, scope, and methodologies, and ensure alignment with organizational… more
- US Tech Solutions, Inc. (Carlisle, PA)
- …associate inquires, including those directed from Associate Service Center. Support audit and regulatory compliance activities. Work on large data sets. ... termination, status, leaves of absence/FMLA, health & wellness insurance claims , disability claims , and paid time off....Cyborg and Control D to review critical HR related audit reports to ensure data integrity by researching and… more
- Percepta (Dearborn, MI)
- …adhere to, and support, all Percepta and internal Business Assistance Center - Audit and Quality Systems initiatives. * Complete training courses as directed by ... needed.Process Smart Vincent/Isis access and role changes requested by C&I.Process ISIS Claims by assigned Region.Research and process claims for Commercial… more
- Careerbuilder-US (Rancho Mirage, CA)
- …and tracking appeals, noting trends, and providing monthly reports. Responds to audit requests (including RAC) from payors. Maintains a Library of Payer reference ... report suspected violations * Analyse denied, underpaid and unpaid claims . Appeal underpaid and denied claims within...and unpaid claims . Appeal underpaid and denied claims within timely filing periods. * Identify, track and… more
- Creative Financial Staffing (Indianapolis, IN)
- …vendors and administer annual 1099 process Calculate commission accruals and audit disbursement requests Administer company's sales/use and personal property tax ... processes Work with Insurance Broker on renewal preparation and claims administration. Support Sales Operations and RFP process by providing relevant company records… more
- Creative Financial Staffing (San Juan, PR)
- …accounts payable, disbursement payments, credit card and merchant facilities, employee claims , and credit control. Ensure effective cash management by forecasting ... policies and maintain robust internal control systems and operational processes for audit review. Collaborate with the LATAM Regional Managing Partner and Business… more
- Stellantis Financial (Houston, TX)
- …credit report information to the major credit bureaus. Works with Compliance to audit and facilitate the correction of data transmitted to all major credit bureaus. ... timely and accurate responses to borrowers and credit repair companies. Investigates claims of identity theft and reviews transactions to ensure the accuracy of… more
- OSI Group (Chicago, IL)
- …needed.Performs daily operational sanitation (SSOP) and GMP inspections during operations.Conduct a Box Audit minimum 2 box daily and Piece Counts one time per line ... Collect and complete data entry for Mac Samples and fat claims as needed.Record-Keeping results for Product temperatures daily.Collects samples and performs… more
- Amerant Bank (Miramar, FL)
- …contact for insurance related matters including but not limited to claims reporting, premium payments, and certificate of insurance requirements. NON-ESSENTIAL ... experience in understanding root cause analysis, fraud prevention, risk mitigation/ audit and data visualization techniques.Minimum Work Experience Requirements:Five years… more
- Prestige Staffing (Atlanta, GA)
- …is responsible for daily posting of payments for Professional and Retail pharmacy claims , posting of zero pay denials, allocating copays to patient balances, running ... unidentified payments to correct lockbox, documenting transactions to maintain adequate audit trail and posts received amounts to lockbox spreadsheet obtained from… more
- Toyota Boshoku (Hopkinsville, KY)
- …customer expectations. G. Oversee and support service part quality issues and warranty claims as necessary. H. Assist in developing quality management system (eg, TS ... multicultural office environment preferred.Personal/Technical Skills: * Working knowledge of quality audit techniques. * Must be trusted with confidential data. *… more
- Clopay Corporation (Georgetown, TX)
- …invoice edit. Audit open order reports weekly.Follow up on customers' claims for credit.Manage all system invoicing on COD and open-term accounts.Manage ... bookkeeping procedures required for setting up and maintaining current open terms and COD accounts, including requisitions for new customer codes.Assist with furnish and install programs whenever necessary, and process furnish and install invoicing and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …any related items. This person may work with managed care payors to resolve claims and related issues in order to enhance managed care contract performance. Supports ... Third-Party Healthcare Arrangements and is able to apply that knowledge.Calculates and audit expected reimbursement in order to determine accuracy of payment.Acts as… more
- Creative Financial Staffing (Tampa, FL)
- …to YellowBook Prepare and provide the necessary documentation to support audit processes The Senior Statutory Accountant will identify opportunities for process ... related to statutory reporting Collaborate with other departments, including underwriting, claims , and actuarial teams, to gather relevant data for statutory… more
- Creative Financial Staffing (Jessup, MD)
- …order and inventory screen and adjustment. Review work orders and pull invoices for claims and file. Assist and provide documents and information during field exam, ... audit or for tax purposes. Qualifications for the Billing Clerk: 2+ years' billing/accounting experience Associates degree or higher education in any field a plus,… more
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