- Elevance Health (Boston, MA)
- …all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + ** Claims Auditor Senior** - all the above, plus : Service as a ... ** Claims Auditor I, II and Senior**...various aspects of the claim including eligibility, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of ... all examiners assigned to the auditor . You will review claims (paid, pending,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… 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
- 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...Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life… 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...Workplace of the Year. This award recognizes hospitals and health systems nationwide that have outstanding levels of employee… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical ... is looking for an experienced medical coding auditor to review inpatient hospital claims for...* Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings * Working knowledge of… 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
- 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
- Elevance Health (Ashburn, VA)
- …an office.** The **DRG Coding Auditor ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… 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 - ... choose among a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death and Dismemberment… 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 (Indianapolis, IN)
- …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 (Buffalo, NY)
- …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
- Northwell Health (Lake Success, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in ... Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and… more
- Covenant Health Inc. (Knoxville, TN)
- …Tennessee as RN with equivalent coding experience. Apply/Share Job Title REV INTEGRITY AUDITOR SR ID 4399754 Facility Covenant Health Corporate Department Name ... Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing… more
- Elevance Health (Atlanta, GA)
- …coding and medical policy guidelines strongly preferred + BA/BS preferred + Medical claims review with prior health care fraud audit/investigation ... monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment… more
- Sharp HealthCare (San Diego, CA)
- …Documentation Specialist (CCDS) - Various-Employee provides certificate; Other; Certified Health Care Compliance (CHC) - Compliance Certification Board **Hours** ... *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… more
- US Bank (Irving, TX)
- …Operations business line. Operations support multiple business lines, including claims , disputes, complaints, electronic payments and call center activities. The ... CAS Staff Auditor is primarily responsible for assisting in completing audit...Strong verbal and written communication skills. + Knowledge of claims /disputes processing, complaints handling, payment services, call center operations… more
- Dignity Health (Rancho Cordova, CA)
- …within the Business Office consistent with the mission and philosophy of Dignity Health Medical Foundation. **Job Requirements** + High school diploma (or ... Qualifications:** + Previous auditing experience preferred **Where You'll Work** Dignity Health Medical Foundation, established in 1993, is a California… more
- Bozeman Health (Bozeman, MT)
- Position Summary: The Compliance Auditor supports an effective compliance program by planning and executing risk-based audits, monitoring adherence to federal and ... coding for compliance. + Intermediate knowledge and experience with electronic health records (EHR) systems (preferably Epic) and compliance/audit management tools.… more
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