• Chief Risk Officer / Legal Affairs / Full-time…

    Children's Hospital Los Angeles (Los Angeles, CA)
    …are a perfect match for every patient. And together, CHLA team members will turn health care into health transformation. Join a hospital where the work you do ... pivotal leadership role is directly accountable for contributing to audit functions, business continuity, claims management, insurance, physical security, integrated… more
    Children's Hospital Los Angeles (06/27/25)
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  • Investigator

    Highmark Health (Sacramento, CA)
    …for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into ... Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated… more
    Highmark Health (08/15/25)
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  • Senior Analyst - IT Auditor

    Lincoln Financial (Sacramento, CA)
    …is a self-starter and initiative driven, ready to take ownership of critical audit processes and thrive in a dynamic, fast-paced environment. This position is ... perfect for someone inclined to leverage their IT Audit (and IT) expertise in an internal audit...risks, and control objectives. + Carry out duties in compliance with all state and federal regulations and guidelines.… more
    Lincoln Financial (08/28/25)
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  • Manager Benefit Administration - Sharp…

    Sharp HealthCare (San Diego, CA)
    …+ AuditsManages responses to both external and internal audits. Ensures workflows support compliance and identifies when audit protocols need to be refreshed to ... more accurately capture day-to-day procedures. Evaluates audit findings and implements new processes to bring Plan...compliance . **Knowledge, Skills, and Abilities** + Knowledge of health insurance or HMO operations with emphasis in the… more
    Sharp HealthCare (08/09/25)
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  • Onsite Pharmacy Auditor (based in California)

    Prime Therapeutics (San Diego, CA)
    …auditing of claims, educating Prime's network pharmacies and driving contract compliance , and supporting downstream claim corrections to eliminate potential waste. ... include in onsite trips considering such information as claim analytic data, prior audit history, and/or referrals, and submit recommended audit plan to manager… more
    Prime Therapeutics (06/28/25)
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  • Benefit Administration Analyst - Sharp…

    Sharp HealthCare (San Diego, CA)
    …responses to both external and internal audits.Assists to ensure workflows support compliance and identify and recommend when audit protocols need to ... into compliance . **Knowledge, Skills, and Abilities** + Knowledge of health insurance or HMO operations with emphasis in the development or application… more
    Sharp HealthCare (08/09/25)
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  • Certified Coding Supervisor - Health

    Ventura County (Ventura, CA)
    …of coders that are not meeting quality standards; prepare audit reports, audit summary analysis of accuracy rate, compliance rate with quality standards and ... Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply  Certified Coding… more
    Ventura County (08/25/25)
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  • Business Manager

    Stanford Health Care (Menlo Park, CA)
    …and requisitioning of capital purchase orders for construction projects, ensuring compliance and efficiency. + **Invoice Processing and Audit :** Oversee ... Hour (United States of America) **This is a Stanford Health Care job.** Located in the heart of Silicon...service line. Monitors all expenditures to ensure adherence and compliance with budget, projected spending trends, controls expenditures and… more
    Stanford Health Care (08/15/25)
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  • Medical Billing Specialist III/IV - Behavioral…

    Ventura County (Ventura, CA)
    …appropriate billing information, and appropriate payment methodology. + Evaluate and identify compliance and audit issues and work progressively with the ... Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply  Medical Billing Specialist… more
    Ventura County (08/27/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (CA)
    …with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition ... Find out how we're constantly improving to make Banner Health the best place to work and receive care....variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding… more
    Banner Health (09/06/25)
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