- Centers Plan for Healthy Living (Staten Island, NY)
- …experience Preferred : Type of Experience Required: 2+ years of claim processing experience with a Medicaid/Medicare Health Plan. Preferred : Experience ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- Billing Auditor for Shared Services Fully Remote * Rochester, Buffalo, or Syracuse, NY * Revenue Cycle Description Billing Auditor for Shared ServicesBuffalo, ... of PPCWNY's mission and the collaboration with Shared Services, the Billing Auditor evaluates Revenue Cycle outcomes to identify and recommend opportunities for… more
- Elevance Health (Latham, NY)
- **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
- New York State Civil Service (Albany, NY)
- NY HELP No Agency SUNY System Administration Title Internal Auditor Occupational Category Financial, Accounting, Auditing Salary Grade NS Bargaining Unit M/C - ... access to records.- Conducts the audit under the supervision of a senior auditor by performing various tests, reviews, reconciliations, and evaluations of accounts, … more
- Highmark Health (Albany, NY)
- …communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Amentum (Albany, NY)
- …on individuals, business entities, and assets. + Analyze large and complex healthcare claims datasets to identify fraud, waste, and abuse patterns. + Design and run ... trends and patterns. + Extract and manipulate federal health claims data using CMS tools such as OnePI, STARS,...standards. + Minimum of three years' experience as an auditor . + Minimum two years specialized experience in the… more
- Molina Healthcare (NY)
- …updates/changes within claims processing system . + Experience using claims processing system (QNXT). ** PREFERRED EDUCATION:** Bachelor's Degree or ... including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to...to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of… more
- Robert Half Accountemps (Albany, NY)
- Description We are seeking a detail-oriented and motivated Auditor to join our clients team on a long-term contract basis. This role will support grant contract ... and email + Familiarity with electronic data systems and document tracking Preferred Qualifications: + Bachelor's degree in Accounting or related field + Minimum… more
- DoorDash (New York, NY)
- …to connect messaging to downstream metrics, from comprehension to NPS to claims behavior. + Brings strong cross-functional leadership and a track record of ... 1099 audiences or with safety/compliance-oriented products. + Bonus: MBA preferred We expect this position to be filled by...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more