- Robert Half Accountemps (Los Angeles, CA)
- …A University Hospital near Los Angeles is seeking a detail-oriented and experienced Medical Clinical Trial Claims Auditor . This role involves meticulous ... Appeals, Medical Denials, Clinical Trial Operations, Clinical trial management, Medical Claims , Claims audits, Coding Audits Robert Half is the world's… 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 ... to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied...Home Health, and minor procedures + Experience with the Claims Life Cycle + Experience with coding/auditing Professional Inpatient… more
- LA Care Health Plan (Los Angeles, CA)
- …in a Health Plan environment. At least 3 years experience as a claims auditor /analyst. Prior experience working with Provider Dispute Resolution (PDR) , ... Claims Quality Auditor II Job Category:... Claims Quality Auditor II Job Category: Claims Department:...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various...tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health… more
- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... + Prior auditing experience is preferred + Knowledge of medical terminology + Knowledge of medical coding...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- University of Utah Health (Murray, UT)
- …years of experience collecting, organizing and maintaining health insurance and processing medical claims , enrollment, and familiarity with medical coding, ... claims and customer service calls for UUHP. + The Claims and Customer Service Auditor reviews claims for processing accuracy in accordance with the… more
- Conduent (Philadelphia, PA)
- …in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor , you will examine a wide variety of pharmacy records against our ... day. **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity Solutions performs… more
- Humana (Columbus, OH)
- …you Come In** Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from...payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments.… 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
- Air National Guard Units (Cheyenne, WY)
- …GUARD TITLE 5 EXCEPTED SERVICE POSITION. This National Guard position is for an AUDITOR , Position Description Number PDT5145P01 and is part of the WY 153rd Airlift ... directions from a higher graded IR Supervisor or IR Auditor if assigned. The purpose is to advise, supervise,...provide transcripts or other documentation to support your educational claims . To receive credit for Education, you must provide… more
- TEKsystems (Chesapeake, VA)
- …documentation + Assigning modifiers to appropriate claims + Researching edited claims for medical necessity, and advising the billing staff of appropriate ... As the Nurse Auditor & Hospital Coder If you're ready to...and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical… more
- ManpowerGroup (New York, NY)
- Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to join our team. The successful candidate will be responsible for ... compliance with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- … record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and ... Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient … more
- Elevance Health (Louisville, KY)
- **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our ... lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by evaluating 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
- 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
- Elevance Health (St. Louis, MO)
- …spending. The **DRG Coding Auditor ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG Coding Auditor (DIAGNOSTIC RELATED GROUP)** _This position will work...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Elevance Health (Metairie, LA)
- …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
- Sherman Associates, Inc. (Minneapolis, MN)
- …neighborhood. This is a Sherman Associates owned Marriott franchised location. The Night Auditor is a key member of the Guest Services team responsible for the ... assisting with all aspects of guest services. The Night Auditor is responsible for ensuring to provide the highest...Offer a Comprehensive Benefits Package Which May Include + Medical , Dental, and Vision Insurance + Employer paid short… more