- Martin's Point Health Care (Portland, ME)
- …Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform the following job functions: + Audit ... Development and Processing: The Auditor II will be responsible for developing and processing...relevant experience. + 5 or more years of related medical claims auditing experience or equivalent experience.… more
- HCA Healthcare (Nashville, TN)
- … Auditor like you to be a part of our team. **Job Summary and Qualifications** The Claims Auditor will serve as a Subject Matter Expert (SME) in medical ... an organization that invests in you as a **Claim Auditor ** ? At Work from Home, you come first....environment, required + Hands-on knowledge and functional understanding of medical claims billing, processing, terminology, diagnosis and… more
- Sedgwick (Columbus, OH)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Compliance Auditor - Workers Compensation **PRIMARY PURPOSE** **:** To ... monitor claims colleague technical activities at a claim file level...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- USAA (Plano, TX)
- …what makes us so special! **The Opportunity** As a dedicated **Senior Auditor ,** you'll perform internal audit assignments. Identify problems for resolution in ... audit test work timely and with high quality. + Executes and may lead as Auditor in Charge (AIC) for audit engagements throughout the audit life cycle, to include… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- … record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and ... Summary With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/ CDM Analyst is responsible for performing audits of… more
- UPMC (Pittsburgh, PA)
- …and revises better best practice within the department. The Intermediate Clinical Auditor Analyst reviews medical records, creates, maintains, and analyzes ... working in collaboration with appropriate Health Plan departments including Quality Improvement, Claims , and Medical Directors as needed to facilitate the… more
- Catholic Health Initiatives (Chattanooga, TN)
- …Coders (AAPC) as a Certified Professional Coder (CPC) required. Professional Medical Auditor Certification (CPMA) (CMAS)-preferred but not required. CRC ... **Overview** **CHI Memorial Mountain Management** CHI Memorial Medical Group (Mountain Management Services), now part of CommonSpirit Health formed between Catholic… more
- Rising Medical Solutions (Chicago, IL)
- …With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, ... that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of … more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta...or more of the following: . Audit experience in medical claims and/or claims data. . ... Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL...with an accounting degree as well as auditing experience, medical claims and/or claims data.… more
- 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 Annually Location...administration and operation of City agencies. Settles all disputed claims in favor of or against the City as… more
- Henry Ford Health System (Troy, MI)
- Reporting to the Manager, Revenue Integrity, the Revenue Integrity Auditor must have a comprehensive understanding of medical terminology, coding, charge entry, ... and healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, coding, billing… more
- Elevance Health (Morristown, NJ)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… 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
- Tennessee Comptroller of the Treasury (Nashville, TN)
- Auditor : Financial/TennCare This role focuses on examining, analyzing, and reviewing records, financial statements, claims data, and cost reports for providers ... The Comptroller of the Treasury is recruiting for a full-time Auditor : Financial/TennCare position in the Division of State Audit's Tenncare/Medicaid Section.… more
- Sedgwick (Knoxville, TN)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Internal Auditor **PRIMARY PURPOSE:** To perform IT internal audit procedures under general ... or university with major in Information Systems preferred. Certified Information Systems Auditor (CISA), Certified Internal Auditor (CIA), or Certified Public… more
- MyFlorida (Miami, FL)
- TAX AUDITOR IV - 79011034 Date: Nov 26, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 842176 Agency: Business and Professional Regulations Working Title: TAX AUDITOR IV - 79011034 Pay Plan: Career Service Position Number: 79011034… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the Audit, Risk Management & Information Security (ARMIS) team, the Senior Internal Auditor will perform and support audits and assessments related to financial and ... to Sarbanes-Oxley), risk-based audits, and consulting engagements. The Senior Internal Auditor will participate in cross-functional projects with IT Audit, Risk… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **UPMC Corporate Finance is hiring a full-time Compliance Auditor , Intermediate. This position will be based out of Forbes Tower in Pittsburgh, PA. This position… more
- Idaho Division of Human Resources (Boise, ID)
- … auditing. Must have the ability to analyze, interpret, and summarize Medicaid claims data, business records, financial records and medical records. Applicants ... Medicaid Fraud Control Unit Investigative Auditor , OAG Posting Begin Date: 2024/10/17 Posting...of Idaho offers a robust total compensation package, including medical , vision, and dental insurance; PERSI retirement benefits; paid… more
- Office of Inspector General (Alexandria, VA)
- …Evaluations Audit Oversight Division. In this position, you will serve as a Supervisory Auditor under a Program Director and will be responsible to perform broad and ... law; Or A certificate as Certified Public Accountant or a Certified Internal Auditor , obtained through written examination; Or Completion of the requirements for a… more