- Molina Healthcare (Rochester, NY)
- JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste, ... overpayments, and claims processing errors. **Essential Job Duties** + Audits the...errors. **Essential Job Duties** + Audits the adjudication of claims using standard principles, and state-specific regulations to identify… more
- New York State Civil Service (Rochester, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Criminal Investigations ... authority;.Represent CID and advocate disputed cases at BCMS conferences and Small Claims .Hearings; may participate at hearings as a witness for the Department… more
- New York State Civil Service (Rochester, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (Audit Division) (NY HELPS) Occupational ... City Rochester State NY Zip Code 14604 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- Sedgwick (Rochester, 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...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Ontario ARC (Canandaigua, NY)
- …USA | Hourly | 21.60-23.00 per hour | Full Time The Arc Ontario Internal Auditor - Programs Salary: $21.60 - $23.00 Position Overview: We're looking for an Internal ... Auditor to join our team and help ensure our...and run efficiently. In this role, you'll audit billing claims , review Individual Service Plans, conduct site visits, and… more
- Molina Healthcare (Rochester, NY)
- …Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... auditing of critical information on claims ensuring adherence to business and system requirements of...& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new clinical staff, as needed. + Mentors (to others… more