- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... possibility of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief Administrative Officer. This position… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- NTT DATA North America (Decatur, IL)
- …Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and ... including pre-determinations and retrospective reviews. + Review submissions by the Claims Department to determine appropriateness of services through established UM… more
- Elevance Health (Chicago, IL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- HUB International (Chicago, IL)
- …success in mergers and acquisitions. **ABOUT THE ROLE** **Summary:** The PBM Auditor is responsible for conducting comprehensive audits of Pharmacy Benefit Managers ... (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data analysis, contract… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Elevance Health (Chicago, IL)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Highmark Health (Springfield, IL)
- …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
- International (Lisle, IL)
- Position Overview International is seeking a strategic and analytical Senior Internal Auditor with a strong foundation in internal controls, audit methodologies, and ... 1831, to the 15,000-person-strong company we are today, few companies can lay claim to a history like International. Based in Lisle, Illinois, International Motors,… more
- Lineage Logistics (Chicago, IL)
- …the plant to determine and ensure meet company standards + Report damages and claims to inventory control + Arrange stock parts in a specific order for assembly ... by other workers + Process inbound/outbound orders safely and accurately **ADDITIONAL DUTIES AND RESPONSIBILITIES** + Work with other machinery and material handling equipment **MINIMUM REQUIREMENTS (KNOWLEDGE, SKILLS, ABILITIES)** + Basic math skills +… more