• Pharmacy Claims Auditor CPhT

    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
    Conduent (06/21/25)
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  • Onsite Pharmacy Auditor (based…

    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
    Prime Therapeutics (06/28/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Walnut Creek, CA)
    **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 (08/23/25)
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  • Coding Auditor Educator

    Highmark Health (Sacramento, CA)
    ** Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
    Highmark Health (08/08/25)
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  • Order Checker Auditor

    Lineage Logistics (Riverside, CA)
    …and virtual product inventories via daily activities of cycle counting, claims management and accounts administration within the facility. Manage data concerned ... handling equipment to move product while following all regulatory and company safety standards, policies, and procedures. **MINIMUM REQUIREMENTS (KNOWLEDGE, SKILLS,… more
    Lineage Logistics (08/12/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Sacramento, CA)
    …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its… more
    Humana (08/23/25)
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  • Claims Examiner

    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
    Insight Global (08/08/25)
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  • Valet Coordinator

    Marriott (Santa Barbara, CA)
    …Provide change to guests. Complete nightly audit of parked vehicles with vehicle claim tickets, resolve discrepancies, and submit list for charges to be posted by ... Night Auditor . Maintain security of vehicles and vehicle keys. Follow all company policies and procedures; report accidents, injuries, and unsafe work conditions… more
    Marriott (08/26/25)
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  • Manager, Financial Compliance Audit, $10,000 Sign…

    LA Care Health Plan (Los Angeles, CA)
    …data by delegates on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements. Manages complex ... including recommendations and corrective action plans requirements. Maintains related company 's policies and procedures ensuring they are current. Proactively… more
    LA Care Health Plan (08/09/25)
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  • Senior Actuarial Analyst

    DoorDash (San Francisco, CA)
    …team at DoorDash is responsible for all things corporate insurance at the company . We are a rapidly growing and exciting function that helps DoorDash manage ... risk and safety with a close lens on the company 's bottom line. We are looking for forward thinkers that are excited to help build out this team and match our… more
    DoorDash (06/06/25)
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