• Pharmacy Claims Auditor CPhT

    Conduent (Dallas, TX)
    …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 (05/31/25)
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  • DRG Coding Auditor

    Elevance Health (Grand Prairie, TX)
    …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
    Elevance Health (05/29/25)
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  • Attorney Auditor

    Sedgwick (Dallas, TX)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +...professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of… more
    Sedgwick (04/09/25)
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  • Inpatient DRG Quality Auditor

    Humana (Austin, TX)
    …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
    Humana (05/30/25)
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  • Coding Auditor Educator

    Highmark Health (Austin, TX)
    ** 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 (05/09/25)
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  • External Audit Facilitator

    Elevance Health (Houston, TX)
    …and audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded ... Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits,… more
    Elevance Health (05/23/25)
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  • Quality Specialist

    CVS Health (Austin, TX)
    …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... all with heart, each and every day. **Position Summary** Claim Audit Quality Analysts need to have a wide...review. A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple… more
    CVS Health (05/30/25)
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  • Manager, Consulting - Legal Bililing Operations

    Wolters Kluwer (Houston, TX)
    …+ 1+ years of prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal industry with 3+ years as ... an attorney, paralegal, legal spend analyst, legal bill auditor , legal bill reviewer, or billing coordinator for law firms. + Ability to obtain information from… more
    Wolters Kluwer (05/14/25)
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