- Centene Corporation (Sacramento, CA)
- …CA - Must be in California **Position Purpose:** The Delegation Oversight Compliance Auditor - Medical Claims is responsible for scheduling, coordinating, ... in provider relations and auditing is preferred. + Previous experience in medical claims processing or auditing is strongly preferred + Excellent written and… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** SHP Claims Auditor (remote) **Cost Center:** 682891379 SHP- Claims **Scheduled Weekly ... Normal (United States of America) **Job Description:** **JOB SUMMARY** The SHP Claims Auditor is responsible for performing payment, procedural accuracy,… more
- WellSpan Health (York, PA)
- Claims Auditor - Quest Behavioral Health - Day Location: York Hospital, York, PA Schedule: Full Time Sign-On Bonus Eligible Remote/Hybrid Regular Apply Now See ... audits to ascertain that the quality of both PPO and TPA claims meets departmental policies, procedures and production standards. Duties and Responsibilities… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Minimum five years of medical claims payment experience in an HMO environment + Experience with CPT-4, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- Conduent (Detroit, MI)
- …of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor ** Location: Remote (US). Pay Rate: $45.5/hour. Work Schedule: Part ... audit, processing, accrual and forecasting of supplier obsolescence and cancellation claims in accordance with GM's Standard Terms and Conditions. Primary… more
- HCA Healthcare (Campbell, CA)
- …quality/performance. **What you will need:** . Subject Matter Expert (SME) in medical claims processing at health plan payor, Managed Services Organization ... Association (IPA) organization . Hands-on knowledge and functional understanding of medical claims billing, processing, terminology, diagnosis and procedures. .… more
- Nevada County (Nevada City, CA)
- Senior Accountant- Auditor -Limited-Term Print (https://www.governmentjobs.com/careers/mynevadacounty/jobs/newprint/4426196) Apply Senior Accountant- Auditor ... Nevada City, CA Job Type Full Time Job Number 2024-0059 Department Auditor -Controller Opening Date 03/13/2024 Closing Date Continuous + Description + Benefits +… more
- Rising Medical Solutions (Milwaukee, WI)
- …With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, ... needs + Being the best, not the biggest The Role: The Senior Medical Bill Auditor will maximize savings for clients by accurately analyzing and processing … 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
- Robert Half Accountemps (Los Angeles, CA)
- …and finalizing DNB edits either in the PFS host Patient Accounting system or claims editing system. At times, the Chart Auditor may conduct insurance audits ... in Los Angeles is in the need of Chart Auditor . The Chart Auditor is responsible for...and conducts high dollar amount defense audits of patient medical records with insurance company representatives to verify documentation… more
- Elevance Health (Plano, TX)
- **Clinical Medical Records Auditor ** A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving ... and the home setting. **Location:** Plano, Texas The **Clinical Medical Records Auditor ** is responsible for the...include, but are not limited to: + Audits provider claims for compliance to standard coding and billing practice… more
- Office of the Inspector General (Sacramento, CA)
- …any other persons or entities doing business with the DOI. As an Auditor (Performance) you will perform assignments as part of complex performance audits, ... findings and explain significance of conclusions reached. You will serve as a Auditor (Performance) under the Pathways Recent Graduates Program within the Office of… 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
- Elevance Health (Columbus, OH)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- Oak Orchard Health (Brockport, NY)
- …Personal Days, Floating Holidays, and Company paid holidays! The Healthcare Compliance Auditor is responsible for investigating medical service providers and ... Healthcare Compliance Auditor Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) * Compliance & Risk Description Do you want to be… more
- United Musculoskeletal Partners (Atlanta, GA)
- **DESCRIPTION** The Coding Quality Auditor and Educator conducts risk-based coding quality audits of provider services encounters to validate code assignment follows ... and regulatory requirements, as supported by clinical documentation in the medical record. This includes performing internal audits, overseeing external audits, and… more
- Elevance Health (Indianapolis, IN)
- …and dollar volume of provider + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical ... 50% in state travel)** **Position Overview:** The LTSS Provider Auditor is a part of the LTSS PR team,...+ Verifies dollar amount on claim is correct in claims system and writes report of the findings of… more
- Elevance Health (San Juan, PR)
- …technology and business operations services for health plans. **Performance Quality Auditor I** **Schedule:** This position will work a first shift monday ... of 9:00 am-6:00 pm Eastern Time. The **Performance Quality Auditor I** is 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