- UCLA Health (Los Angeles, CA)
- …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,...maintain statistical data consistent + Maintain departmental production and quality standards _Note: This posted position is 1 of… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten...keep up to date with departmental changes in conducting quality reviews. + Ensure the consistent use of current ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … 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, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- HCA Healthcare (Campbell, CA)
- …and integrity. We care like family! Jump-start your career as a(an) Claim Auditor today with HCA Healthcare. **Benefits** HCA Healthcare, offers a total rewards ... by location._** Come join our team as a(an) Claim Auditor . We care for our community! Just last year,...function is to ensure examiner payment accuracy of all claims processing including analysis of support services fulfillment colleagues'… more
- Fallon Health (Worcester, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Elevance Health (Cincinnati, OH)
- **Title: Performance Quality Auditor III** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of one of our PulsePoint locations. The **Performance Quality Auditor III** will be responsible for...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot ... Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL...of Georgia by providing legal representation of the highest quality to the agencies, officers and employees of state… more
- National Nuclear Security Administration (Pittsburgh, PA)
- …contact the HR Consultant listed on this vacancy announcement. Responsibilities As the Lead Auditor , you will: Serve as Lead Auditor within the Naval Reactors ... AND IOR: All Professional Auditor Positions: https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/0500/auditing-series-0511/ Experience… more
- Hackensack Meridian Health (Hackensack, NJ)
- …ensuring coding accuracy, coding consistency and efficiency in filing of inpatient claims . Collaborates with the Clinical Documentation Quality Liaison to assist ... as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for… 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
- United Musculoskeletal Partners (Atlanta, GA)
- **DESCRIPTION** The Coding Quality Auditor and Educator conducts risk-based coding quality audits of provider services encounters to validate code assignment ... a key member of the Coding team the Coding Quality Auditor and Educator: + Conducts coding,...coding accuracy of all documented diagnoses and procedures. Reviews claims to validate submitted codes and abstracted data including… more
- Oak Orchard Health (Brockport, NY)
- Healthcare Compliance Auditor Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) * Compliance & Risk Description Do you want to be ... a leading, patient-centered organization where professionals come together to improve access to quality health care for all? At Oak Orchard Health, you can grow your… more
- Fallon Health (Worcester, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Elevance Health (Indianapolis, IN)
- …The LTSS Provider Auditor is a part of the LTSS PR team, supporting quality in service delivery. The LTSS Provider Auditor is responsible for quality ... volume of provider + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical notes, itemized… more
- Hackensack Meridian Health (Hackensack, NJ)
- …a leader of positive change. The **Ambulatory Payment Classification (APC) Auditor ** performs all related internal, concurrent, prospective and retrospective coding ... Hackensack Meridian Health (HMH) network. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to APC's, ICD… more
- Pension Benefit Guaranty Corporation (Washington, DC)
- …Twenty-four semester hours in accounting or auditing courses of appropriate type and quality . This can include up to 6 hours of business law; A certificate ... as Certified Public Accountant or a Certified Internal Auditor , obtained through written examination; or Completion of the requirements for a degree that included… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Inpatient Auditor and Educator Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's top-performing ... coders. Serves as a resource to coders, CDI staff, Quality and Case Managers, Decision Support and physician office...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- Highmark Health (Jefferson City, MO)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… more
- BrightSpring Health Services (Louisville, KY)
- …audits to ensure billing requirements are met prior to submission of home health claims and working with the billing department and home health agencies to resolve ... health agency regarding information needed to ensure timely and accurate filing of claims + Assists the agencies with troubleshooting to resolve issues holding … more
- LA Care Health Plan (Los Angeles, CA)
- …department for compliance with regulatory requirements. Ensures all work performed within the claims department is of the highest quality and is well documented. ... Manager, Claims Job Category: Claims Department: ...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more