- LA Care Health Plan (Los Angeles, CA)
- …a Health Plan environment. At least 3 years experience as a claims auditor /analyst. Prior experience working with Provider Dispute Resolution (PDR) , third ... Claims Quality Auditor II Job Category:...(Mid.) - $107,498.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by… more
- Medical Mutual of Ohio (OH)
- …of clinicaland medical auditing experience. **Professional Certification(s)** + Certified Medical Auditor (if not certified required to obtain within 18 ... experience, DRG,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** **Clinical Auditor ** + **Audits outpatient, inpatient and professional claims… more
- CGI Technologies and Solutions, Inc. (Fairfax, VA)
- …with other audit team members. **Your future duties and responsibilities:** * Reviews medical records to identify recovery opportunities on claims for outpatient ... **Outpatient Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main...the identification of improper payments (overpayments and underpayments) on claims paid to various providers of clinical services, including… more
- Elevance Health (Indianapolis, IN)
- **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 ... PulsePoint locations. A proud member of the Elevance Health family of companies, CarelonRx leverages the power of new technologies and a strong, clinical-first lens,… more
- Nevada County (Nevada City, CA)
- Accountant- Auditor II - Limited-Term Print (https://www.governmentjobs.com/careers/mynevadacounty/jobs/newprint/4426192) Apply Accountant- Auditor II - ... Nevada City, CA Job Type Limited Term Job Number 2024-0058 Department Auditor -Controller Opening Date 10/01/2024 Closing Date 10/15/2024 8:00 AM Pacific +… more
- Dignity Health (Phoenix, AZ)
- …the department. Must be a** **Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA)** Dignity Health now offers an Education ... **Overview** Hello humankindness Dignity Health Medical Group is the employed...Cerner. + Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA) **PREFERRED** + Previous auditing… more
- Nevada County (Nevada City, CA)
- Senior Accountant- Auditor -Limited-Term * * * $3,000 HIRING BONUS * * * Print (https://www.governmentjobs.com/careers/mynevadacounty/jobs/newprint/4426196) Apply ... Senior Accountant- Auditor -Limited-Term * * * $3,000 HIRING BONUS * *...implementation of new GASB pronouncements + Prepare and file claims and reports with various governmental regulatory agencies The… more
- Elevance Health (Columbus, OH)
- …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
- 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
- Rising Medical Solutions (Chicago, IL)
- …With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, ... business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor...within! + Opportunity to make a difference in reducing health care costs and increasing the value of … more
- Elevance Health (Columbus, OH)
- …reside within a 50-mile or 1-hour commute each way of a relevant Elevance Health location. The **Performance Quality Auditor lll** is responsible evaluating the ... **Location:** Elevance Health supports a hybrid workplace model (virtual and...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …concurrent, prospective and retrospective coding audit activities across the Hackensack Meridian Health (HMH) network. Reviews medical records to determine data ... A day in the life of a **Ambulatory Payment Classification (APC) Auditor ** at **Hackensack Meridian** **_Health_** includes: + Assist with developing coding quality… more
- Covenant Health Inc. (Knoxville, TN)
- …are acceptable-RHIT/RHIA/AAPC, CPC, or CPMA. Apply/Share Job Title CODING OFF AUDITOR -EDU ID 3865895 Facility Covenant Health Corporate Department Name ... Overview Inpatient Auditor and Educator Full Time, 80 Hours Per...Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's… 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
- SSM Health (St. Louis, MO)
- …related to Clinical Documentation Improvement, Utilization Management and compares against medical bills, claims and revenue reports. + Participates in ... **It's more than a career, it's a calling** MO-SSM Health Mission Hill **Worker Type:** Regular **Job Highlights:** RN-Clinical Auditor Manager, Care… more
- Sedgwick (Knoxville, TN)
- …regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Internal Auditor - IT **PRIMARY PURPOSE:** To perform IT internal audit procedures under… more
- Nuvance Health (Danbury, CT)
- …and State guidelines. Ensure correct DRG and APC assignments for Institutional claims . 2. Maintains confidentiality of protected health information and other ... policies, ie, Center for Medicare & Medicaid Services (CMS), American Medical Association (AMA), American Health Information Management Association (AHIMA), to… more
- UCLA Health (Los Angeles, CA)
- …working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record audits for physicians ... Description As the Medicare Advantage Risk Adjustment Provider Documentation Trainer and Auditor , you will be an expert in risk adjustment coding and documentation,… more
- New York State Civil Service (Syracuse, NY)
- …and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the position qualifies ... HELP No Agency Attorney General, Office of the Title Forensic Auditor : Support Healthcare Fraud Investigations (6342) Occupational Category Financial, Accounting,… more
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