- Elevance Health (St. Louis, MO)
- **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Elevance Health (St. Louis, MO)
- **Clinical Provider Auditor I** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor I** is responsible for identifying issues and/or entities that… more
- Elevance Health (St. Louis, MO)
- …each way of a relevant Elevance Health location. The **Performance Quality Auditor lll** is responsible evaluating the quality of services and interactions provided ... Included are processes related to enrollment and billing and claims processing, as well as customer service written and...audits, generally related to multiple functions on the WGS claims system for multiple lines of business. + Works… more
- SSM Health (St. Louis, MO)
- …MO-SSM Health Mission Hill **Worker Type:** Regular **Job Highlights:** RN-Clinical Auditor Manager, Care Transformation - Case Management and Social Work 7 ... Clinical Documentation Improvement, Utilization Management and compares against medical bills, claims and revenue reports. + Participates in training of specific… more
- Molina Healthcare (St. Louis, MO)
- …can be located anywhere in the US **Job Summary** The Sr Auditor , Delegation Oversight will independently perform audits of multi-delegated functions with minimal ... and State Medicaid entities. **Job Duties** + Oversees Utilization Management, Claims , Organizational Credentialing, and Crisis Call Center delegated activities. +… more