• Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...keep up to date with departmental changes in conducting quality reviews. + Ensure the consistent use of current… more
    Centers Plan for Healthy Living (07/15/25)
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  • Inpatient DRG Quality Auditor

    Humana (Albany, NY)
    …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
    Humana (07/25/25)
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  • Billing Auditor for Shared Services

    Planned Parenthood of Central and Western NY (Rochester, NY)
    Billing Auditor for Shared Services Fully Remote * Rochester, Buffalo, or Syracuse, NY * Revenue Cycle Description Billing Auditor for Shared ServicesBuffalo, ... of PPCWNY's mission and the collaboration with Shared Services, the Billing Auditor evaluates Revenue Cycle outcomes to identify and recommend opportunities for… more
    Planned Parenthood of Central and Western NY (07/25/25)
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  • Food Safety & Food Quality Auditor…

    Boar's Head Brand/Frank Brunckhorst Co., LLC (Brooklyn, NY)
    …required (ie American Society for Quality - Certified Food Safety & Quality Auditor , Certified Supplier Quality Professional and/or able to obtain ... the Boar's Head Audit Team in conducting comprehensive Food Safety and Product Quality audits across a variety of venues, including Food Service Operations, Retail… more
    Boar's Head Brand/Frank Brunckhorst Co., LLC (07/01/25)
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  • Insurance Internal Auditor

    ManpowerGroup (New York, NY)
    Jefferson Wells is seeking an experienced **Insurance Auditor with Life Claims ** expertise to join our team. The successful candidate will be responsible for ... compliance with company policies, industry standards, and regulatory requirements. The auditor will analyze the claims documentation and processes, identify… more
    ManpowerGroup (07/12/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Latham, NY)
    …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
    Elevance Health (07/17/25)
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  • Internal Auditor

    New York State Civil Service (Albany, NY)
    NY HELP No Agency SUNY System Administration Title Internal Auditor Occupational Category Financial, Accounting, Auditing Salary Grade NS Bargaining Unit M/C - ... SUNY campuses, employees, and students to advance SUNY's mission of providing high- quality , affordable higher education for all.Across a wide range of roles, from… more
    New York State Civil Service (06/24/25)
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  • Coding Auditor Educator

    Highmark Health (Albany, NY)
    …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
    Highmark Health (05/09/25)
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  • Capital Payment Auditor

    City of New York (New York, NY)
    …We provide sidewalks, street reconstruction, water mains, sewers, and pedestrian ramps quality infrastructure that is essential for a healthy, resilient city. To ... 4500 payment requests annually. DDC seeks a Capital Payment Auditor to review and process these payment requisitions. To...(in FMS3); and adjust payment voucher(s) due to liens, claims and assignments. The candidate will use the DDC… more
    City of New York (06/25/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Albany, NY)
    …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
    Humana (07/29/25)
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