- Conduent (Los Angeles, CA)
- …pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against ... of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to… more
- Insight Global (Los Angeles, CA)
- …skills Ability to work independently and collaboratively In-depth knowledge of healthcare regulations and claims processing systems Reliable transportation for ... Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health systems in...person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare 's ... and procedures. The position plays a key role in oversight of Sharp HealthCare 's (SHC) compliance audit function and maintaining Sharp HealthCare 's view of… more
- Humana (Sacramento, CA)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Elevance Health (Walnut Creek, CA)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Highmark Health (Sacramento, CA)
- …Depending on location provides or arranges for education/training of facility healthcare professionals in use of coding guidelines and practices, proper ... Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician...skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and… more
- Humana (Sacramento, CA)
- …for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must be able to work core business hours on EST time between ... of compliance risk across the organization. This team ensures that healthcare providers align their operational practices with legal requirements while fostering… more
- DoorDash (Sunnyvale, CA)
- …and safety alerts, provide instant support when incidents occur, and streamline claims through automated processes-all while gathering invaluable data that makes our ... 29, 2024. The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here: Covey (https://getcovey.com/nyc-local-law-144)… more
- DoorDash (San Francisco, CA)
- …and audit requirements + Collaborate closely with outside counsel, in-house attorneys, claims professionals, and safety teams to move cases forward + Contribute to ... 29, 2024. The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here: Covey (https://getcovey.com/nyc-local-law-144)… more
- DoorDash (San Francisco, CA)
- …automation of recurring workflows + Collaborate with cross-functional teams-including Claims , Finance, and Legal-to incorporate operational insights into actuarial ... 29, 2024. The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here: Covey (https://getcovey.com/nyc-local-law-144)… more
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