- 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
- Molina Healthcare (Syracuse, NY)
- …skills. + Microsoft Office suite and applicable software programs proficiency. ** Preferred Qualifications** + Health care claims auditing/billing experience. To ... JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste,… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- Humana (Albany, NY)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Humana (Albany, NY)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural ... terminology and medical codes (eg, ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the… more
- Ontario ARC (Canandaigua, NY)
- …USA | Hourly | 21.60-23.00 per hour | Full Time The Arc Ontario Internal Auditor - Programs Salary: $21.60 - $23.00 Position Overview: We're looking for an Internal ... Auditor to join our team and help ensure our...and run efficiently. In this role, you'll audit billing claims , review Individual Service Plans, conduct site visits, and… more
- Humana (Albany, NY)
- …Bachelor's degree - Accounting, Finance, Business, Auditing, Actuarial + Certified Internal Auditor , CPA or CPC strongly preferred + Risk Adjustment knowledge ... + Auditing experience + Familiarity with CMS Reimbursement models and claims /encounter submission processes + Data analysis and dashboarding experience + People… more
- SUNY Upstate Medical University (Syracuse, NY)
- …CCS, or CCS-P. + Specialty certification such as COBGC (Certified OB/GYN Coder) preferred . + CPMA (Certified Professional Medical Auditor ) or CDEO (Certified ... and compliance training. + Support revenue cycle teams in addressing claim denials, coding queries, and charge reconciliation. Education, Training and Previous… more
- Amazon (New York, NY)
- …ongoing financial and risk analysis. -Support ongoing actuarial support for outside auditor review of financial estimates and results. -Design studies to monitor the ... of actuarial reserving, forecasting and medical economics -Expertise in working with medical claims data and using programming languages such as SQL, R, SAS, Python,… more