• Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor . You will review claims (paid, pending,...+ Computer proficiency with Microsoft Office + Knowledge of claims adjudication systems + Flexibility and adaptability… more
    UCLA Health (08/08/25)
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  • Onsite Pharmacy Auditor (based…

    Prime Therapeutics (San Diego, CA)
    …procedures and objectives + Leverage professional pharmacy technician knowledge to validate claim documentation and systems data while onsite to ensure ... passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor more
    Prime Therapeutics (06/28/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Costa Mesa, CA)
    …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
    Elevance Health (08/09/25)
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  • Coding Auditor Educator

    Highmark Health (Sacramento, CA)
    …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
    Highmark Health (08/08/25)
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  • Compliance Coding Auditor

    Sharp HealthCare (San Diego, CA)
    **Facility:** System Services **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified ... and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's)… more
    Sharp HealthCare (07/13/25)
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  • Auditor II- Ethics Commission

    City and County of San Francisco (San Francisco, CA)
    …effective operations within the Commission. Auditors also play a key role in reviewing claims for public financing to ensure that City funds are only distributed to ... Qualifications + Professional certification as a Certified Public Accountant, Certified Internal Auditor , or Certified Fraud Examiner. + A Master's degree in public… more
    City and County of San Francisco (07/31/25)
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  • Claims Examiner

    Insight Global (Irvine, CA)
    …terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation, quality assurance process, ad-hoc ... will assist management with implementation of measures to ensure claim processing and payment accuracy. They will also help...working with excel In the job experience of EHR systems and medical insurance claims management softwares… more
    Insight Global (08/08/25)
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  • Principal Accounting Systems Technician

    The County of Los Angeles (Los Angeles, CA)
    …(1) year's professional auditing or accounting experience** at the level of Senior Accountant- Auditor , Senior Accounting Systems Technician , Senior Accounting ... auditing or accounting experience at the level of Senior Accountant- Auditor , Senior Accounting Systems Technician ,...and assign a score based on a standardized scoring system . This part of the assessment is worth 100%… more
    The County of Los Angeles (05/14/25)
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  • Senior/Principal Accountant-MB

    Ventura County (Ventura, CA)
    …are eligible, you may establish reciprocity with other public retirement systems , such as PERS. + Additional Benefits: Professional Memberships, Disability Plans, ... Management staff, CEO Budget and Finance, GSA Procurement, and the Auditor Controller's Accounts Payable, Financial Planning, and Financial Reporting staff.… more
    Ventura County (06/02/25)
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  • Accountant I/II/Senior

    Ventura County (Ventura, CA)
    …(Accountant I) or calculates and analyzes (Accountant II) Incurred but not Reported medical claims based on system generated claim lag reports to provide ... routine duties while learning the assigned program area's fiscal policies, procedures, systems , operations and practices. As experience is gained, and over a period… more
    Ventura County (06/02/25)
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