- Warner Music Group (New York, NY)
- …the contractually-defined scope) of the audit concerned; + Review and analyze the audit claims submitted by the auditor in question, as well as the relevant ... including, without limitation, tracking audit notifications, reviewing and analyzing the claims contained in the audit reports we receive, making recommendations to… more
- Humana (Columbus, OH)
- …evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Sedgwick (Buffalo, NY)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- AmeriHealth Caritas (Philadelphia, PA)
- …audit process and communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case is migrated appropriately. ... post-implementation review is completed as the policy outlines. The auditor will be expected to build/run complex queries to...will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all… more
- Northwell Health (Lake Success, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in ... Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and… 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 ... or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks… more
- Sharp HealthCare (San Diego, CA)
- …factors, other requirements for the position, and employer business practices. *This is a remote position* **What You Will Do** The Compliance Coding Auditor is ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …a dedicated Coding Auditor to join our team and perform thorough claims payment quality and clinical coding compliance audits\. Your role will be pivotal in ... results to appropriate parties; recommending corrective course of action\. + Conducting claims audits and serving as subject matter expert to management and internal… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote . This person should have an extensive background in ... is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …member of the Audit and Risk Management (ARM) team, the Senior Internal Auditor will lead and execute a variety of financial, operational, and risk-based audits ... reporting and risk-based audits of these areas (eg Enrollment, Premiums, Claims Operations, Provider Enrollment and Pricing, Accounting, and Information Technology… more
- Covenant Health Inc. (Knoxville, TN)
- …Per Pay Period, Day Shift Must be located in East TN. Position is remote and onsite. Covenant Medical Group is Covenant Health's employed and managed medical ... to ensure compliance. + Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure compliance. + Performs… more
- Healthfirst (NY)
- **This position is 100% Remote .** **Scope of Responsibilities:** + Conduct moderately complex to complex quality audits of provider claims , pre-payments and ... to ensure the quality of the network. + Review and investigate claims and encounters for medical, facility, pharmacy, dental and vision services including… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will ... Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be… more
- DoorDash (Tempe, AZ)
- …company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward ... DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's...Notice to Applicants for Jobs Located in NYC or Remote Jobs Associated With Office in NYC Only We… more
- RTX Corporation (Hartford, CT)
- **Date Posted:** 2025-11-20 **Country:** United States of America **Location:** PW208: Connecticut Remote Remote Location , Remote City, CT, 06035 USA ... you ready to go beyond?** We have an exciting ** remote ** work opportunity for a **Manager, Global Trade** !...Will Do:** + Support valuation reconciliation. + Support drawback claims . + Support post summary corrections. + Support resolution… more
- Trinity Health (Albany, NY)
- …Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team ... diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system.... Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. **Core Values:** .… more
- Actalent (Des Moines, IA)
- Remote HEDIS Nurse Consultant Description HEDIS work typically includes requesting records, abstracting/overreading medical records, performing claims research, ... preparing medical records for the NCQA HEDIS Auditor , etc. Abstracts medical record data from practitioner's files...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, ... correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, abstracting,… more
- McKinstry (Spokane, WA)
- …+ Drive continuous improvement projects to reduce defects, rework, and warranty claims , using production quality data to identify and prioritize activities and ... Manufacturing preferred. + Lean Belt Certification preferred. + SO 9001:2015 Lead Auditor certification. + Working knowledge and understanding of the ISO 9001:2015… more
- DoorDash (Tempe, AZ)
- …of DoorDash operations through adjudication of background checks and insurance claims , investigation of safety incidents, and implementation of quality measures for ... Notice to Applicants for Jobs Located in NYC or Remote Jobs Associated With Office in NYC Only We...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more
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