- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...results to recommend system or procedural changes to increase claim accuracy and/or identify opportunities for workflow enhancements. +… more
- Molina Healthcare (Syracuse, NY)
- JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste, ... overpayments, and claims processing errors. **Essential Job Duties** + Audits the...errors. **Essential Job Duties** + Audits the adjudication of claims using standard principles, and state-specific regulations to identify… more
- Humana (Albany, NY)
- …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
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE MANAGEMENT AUDITOR CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE. IF ... YOU ARE HIRED PROVISIONALLY AS A MANAGEMENT AUDITOR , YOU MUST TAKE AND PASS THE MANAGEMENT ...standard audit procedures examine records and documents that support claims submitted to Medicaid for reimbursement for goods or… more
- New York State Civil Service (Hauppauge, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Occupational Category ... City Hauppauge State NY Zip Code 11788 Duties Description Auditor 1 (Tax) performs on-site field audits and examinations...and advocate disputed cases at BCMS conferences and Small Claims Hearings. May participate at hearings as a witness… more
- New York State Civil Service (White Plains, NY)
- NY HELP Yes Agency Taxation & Finance, State Title Auditor 1 (Tax)/ Auditor Trainee 1 (Tax)/ Auditor Trainee 2 (Tax) (NY HELPS) Criminal Investigations ... authority;.Represent CID and advocate disputed cases at BCMS conferences and Small Claims .Hearings; may participate at hearings as a witness for the Department… more
- Humana (Albany, NY)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Sedgwick (Buffalo, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- City of New York (New York, NY)
- …daily claims reports and the monthly reports which detail claim associated fees to ensure compliance with contractual obligations, regulatory requirements, and ... requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. 2. Claims Data Validation: Verify the… more
- Humana (Albany, NY)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural ... terminology and medical codes (eg, ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the… more