- 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
- 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 ** **_Virtual_** **_: _** _ _ __ _This...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- Sedgwick (San Antonio, TX)
- …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...Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +… more
- 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
- Elevance Health (Grand Prairie, TX)
- **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
- Elevance Health (Houston, TX)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ **Virtual:** This role enables associates to work virtually ... 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 (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
- Humana (Austin, TX)
- …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
- Elevance Health (Grand Prairie, TX)
- **PBM Compliance Manager ( Claims Audit)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **PBM Compliance Manager ( Claims Audit)** is responsible for coordinating pharmacy compliance activities and initiatives… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …a Quality Assurance Manager in a manufacturing setting + A Certified Aerospace Auditor certification is preferred + Qualified candidates must be an ASQ Certified ... Manager of Quality/OE, Certified Quality Auditor or a Certified Quality Inspector + Experience with...online, driving course to be authorized to drive for company purposes. UIC is an equal opportunity employer. We… more