- Centers Plan for Healthy Living (Staten Island, NY)
- …teams to match the unique strengths of each individual, tiered roles to support the advancement, and with opportunities for cross-training and education, CPHL is the ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … 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
- New York State Civil Service (Pearl River, NY)
- …HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Complex Healthcare Fraud, 6405 Occupational Category Financial, Accounting, ... Medicaid Fraud Control Unit - Pearl River (Rockland County)Forensic Accountant/ Auditor Reference No. MFCU_PR_FAA_6405Application Deadline is October 31, 2025Salary… more
- City of New York (New York, NY)
- …guides our work providing City agencies with the critical resources and support needed to succeed, including: - Recruiting, hiring, and training City employees. ... one agency, but in service of them all. It's an opportunity to provide impactful support , quality customer service, and help protect the future of New York City for… more
- City of New York (New York, NY)
- …reports. - Participates in and reviews the processing of fiscal documents, claims , financial statements, and the accounting for the receipt, deposit and disbursement ... managerial lump sum payments and updating agency policies and procedures. - Support audits, reviews, and inspection/salvage of electronic equipment. - Respond to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Analysis Project* IT Audit project assistance* Attend operational audit planning meetings* Support Auditor in Charge with testing of operational audit(s)* ... Control Testing in various process areas such as entity level controls, claims , enrollment operations, IT general computer, and application related controls, etc.*… more
- City of New York (New York, NY)
- …PERMANENT EMPLOYEES IN THE TITLE AND THOSE THAT ARE REACHABLE ON THE MANAGEMENT AUDITOR CIVIL SERVICE LIST ARE ELIGIBLE TO APPLY. CANDIDATES MUST STATE THE TITLE ... develop and maintain a strong financial infrastructure to enable and support the delivery of high-quality, effective, and impactful contracted services. The… more
- Albany Medical Center (Albany, NY)
- …Under the direction of the Director of Pharmacy the Pharmacy Revenue Integrity Auditor will serve as a pharmacy liaison and interface with finance, billing, revenue ... billing practices by reviewing patient records, medication orders, and insurance claims to identify and correct potential pharmaceutical billing errors. They are… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new clinical staff, as needed. + Mentors (to others… more
- University of Rochester (Rochester, NY)
- …Compliance Billing, Coding, and Education Analyst** Provides compliance oversight and support for assigned clinical specialties across URMC and Affiliates in ... education and training. **2: Compliance Specialist** Provides compliance oversight and support across URMC and Affiliates in accordance with OIG and OMIG… more