- Conduent (Los Angeles, CA)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- UCLA Health (Los Angeles, CA)
- …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, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- Prime Therapeutics (San Diego, CA)
- …passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor ... pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III, $5,000 SIGN ON BONUS Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III is offering a $5,000 Sign On Bonus....and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors.… 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 - ... No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- Elevance Health (Costa Mesa, CA)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Highmark Health (Sacramento, CA)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... 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
- City and County of San Francisco (San Francisco, CA)
- …effective operations within the Commission. Auditors also play a key role in reviewing claims for public financing to ensure that City funds are only distributed to ... Qualifications + Professional certification as a Certified Public Accountant, Certified Internal Auditor , or Certified Fraud Examiner. + A Master's degree in public… more
- Insight Global (Burbank, CA)
- …benefits used. - Prepare files for referral to Trust Counsel and refer compensation claims to the client. - Process monthly internal reports and create work reports ... for contributions from client settlements. - Assist with special projects as assigned. - Respond to participant and employer inquiries about contributions, reporting rules, and project ceilings. - Provide excellent customer service through phone and email… more
- Insight Global (Irvine, CA)
- …terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation, quality assurance process, ad-hoc ... An employer in the Irvine area is seeking a Claims Examiner II. This is a hybrid position, working...will assist management with implementation of measures to ensure claim processing and payment accuracy. They will also help… more