• 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 (06/21/25)
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  • Medical Audit Field Auditor

    WTW (Dallas, TX)
    **Description** As a Field Auditor , you will apply your medical claims audit, project management and claim processing and auditing experience to perform ... environment + Claims processing knowledge/exposure to one or more administrator claim systems such as UNET, WGS, NASCO, ACAS, Proclaim, PowerMHS, Facets, ITS,… more
    WTW (08/08/25)
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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 ** **_Virtual_** **_: _** _ _ _​_ _This...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
    Elevance Health (07/22/25)
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  • Attorney Auditor

    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
    Sedgwick (07/09/25)
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  • Diagnosis Related Group Clinical Validation…

    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 (08/09/25)
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  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually full-time, with the ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
    Elevance Health (08/08/25)
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  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    **Clinical Provider Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training sessions, ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II i** s responsible for identifying issues and/or entities that… more
    Elevance Health (08/08/25)
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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 (08/08/25)
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  • PBM Compliance Manager ( Claims Audit)

    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
    Elevance Health (07/29/25)
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  • Quality Assurance Manager

    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
    UIC Government Services and the Bowhead Family of Companies (06/23/25)
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