- UCLA Health (Los Angeles, CA)
- …career 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,...maintain statistical data consistent + Maintain departmental production and quality standards Salary Range: $31.51 - $62.64 HourlyQualifications We're… more
- Humana (Sacramento, CA)
- …looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization,… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all aspects of planning, execution,… 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,...+ 2 years of work experience in audit or quality assurance + 1 year of work experience in… more
- Elevance Health (Walnut Creek, CA)
- …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... **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
- 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) ... audit program. The position provides oversight and maintenance of a high- quality , effective, best practices coding, billing, and reimbursement audit compliance… more
- Highmark Health (Sacramento, CA)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… 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
- Humana (Sacramento, CA)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more
- Ventura County (Ventura, CA)
- …Management staff, CEO Budget and Finance, GSA Procurement, and the Auditor Controller's Accounts Payable, Financial Planning, and Financial Reporting staff. ... organizations/departments regarding fiscal issues and policies. + Assists the Auditor -Controller's Office/State Controller's Office with the preparation of financial… more