- Elevance Health (Boston, MA)
- ** Claims Auditor I, II and Senior** **Location...interprets Medical Policy and Clinical Guidelines. + ** Claims Auditor Senior** - all the above, plus ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...various aspects of the claim including eligibility, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… 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)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... day shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy,… more
- US Tech Solutions (Whittier, CA)
- …: Day** **Next Start date: Immediately** **Contract length: 3 months** **POSITION SUMMARY** The Claims Auditor assists in the Claims Department by analyzing ... will be indicated by a high school diploma or equivalent; four years medical claims processing. **Preferred:** *Department Management to list. **DUTIES AND… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... 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 (Warren, MI)
- …part of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor ** **Hybrid | Warren, MI** **Part-Time | Hours Assigned as ... 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor , you'll play a vital role...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… more
- Cedars-Sinai (Los Angeles, CA)
- …fuels innovation. **Req ID** : 13340 **Working Title** : Outpatient Surgical and Claims Edit Auditor **Department** : CSRC Coding Audit **Business Entity** : ... 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded...will I be doing in this role?** The Coding Auditor works under the general direction of the Coding… more
- UPMC (Pittsburgh, PA)
- …software to assess and monitor for potential FWA. + Review and analyze claims , medical records and associated processes related to the appropriateness of ... substances, prescribing of controlled substances, or medically appropriate services. + Query medical and/or pharmacy claims and conduct a risk assessment by… more
- Humana (Columbus, OH)
- …variable factors. 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
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other… more
- The County of Los Angeles (Los Angeles, CA)
- LAW ENFORCEMENT AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4668332) Apply LAW ENFORCEMENT AUDITOR Salary $109,807.68 - ... a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- Humana (Topeka, KS)
- **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to ... medical codes (eg, ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately...NCD, and Coding Guidelines + Experience reading and interpreting claims + Excellent written and verbal communication skills +… more
- The Cigna Group (Detroit, MI)
- The Pharmacy Auditor is responsible for identifying pharmacy audit risks using analytical skills and audit tools, and for developing and executing audit plans and ... the scope of procedures necessary to address those risks. The Staff Auditor will complete audits to address identified risks and present findings to the Sr Audit… more
- Elevance Health (Chicago, IL)
- …spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...environment preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Sedgwick (Charlotte, NC)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
- Elevance Health (Chicago, IL)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Elevance Health (Chicago, IL)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- Sedgwick (Indianapolis, IN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Internal Auditor **PRIMARY PURPOSE OF THE ROLE:** To perform internal audit procedures under ... accounting field strongly preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or certified Information Systems Auditor (CISA)… more
- Cedars-Sinai (Los Angeles, CA)
- …The Physician Compliance Auditor is responsible for reviewing and auditing claims , medical records, and charges to ensure compliance with applicable ... 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded...Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with documentation, coding,… more
- Sharp HealthCare (San Diego, CA)
- …*This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… more