- Conduent (Los Angeles, CA)
- …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 ... pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against our… more
- 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, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- Insight Global (Irvine, CA)
- …with strong understanding of medical terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation, ... An employer in the Irvine area is seeking a Claims Examiner II. This is a hybrid position, working...be responsible for the investigation, determination, and reporting of claims processing through auditing billing processes, including pre and… more
- The County of Los Angeles (Los Angeles, CA)
- LAW ENFORCEMENT AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4668332) Apply LAW ENFORCEMENT AUDITOR Salary $109,807.68 - ... No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III, $5,000 SIGN ON BONUS Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III is offering a $5,000 Sign On Bonus....and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors.… more
- Prime Therapeutics (San Diego, CA)
- …passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor ... and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance,...to Prime's travel and expense policy + Analyze pharmacy claims to identify those at the highest risk for… more
- Elevance Health (Costa Mesa, CA)
- **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
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… more
- Highmark Health (Sacramento, CA)
- …Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… more
- 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