- Elevance Health (Norfolk, VA)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Elevance Health (Roanoke, VA)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Highmark Health (Richmond, VA)
- …Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal , concurrent, prospective and retrospective coding audit activities. Reviews medical ... with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts… more
- Lincoln Financial (Richmond, VA)
- …#:** 74448 **The Role at a Glance** We are seeking an enthusiastic Senior IT Auditor who is a self-starter and initiative driven, ready to take ownership of critical ... leverage their IT Audit (and IT) expertise in an internal audit environment, while focusing on an in-depth review...risks, and control objectives. + Carry out duties in compliance with all state and federal regulations and guidelines.… more
- SimIS Inc. (Norfolk, VA)
- …analyses to support the NATO Allied Command Transformation (ACT) Office of Internal Audit in performing compliance and integrity audits, inspections, reviews, ... environments, requirements, and capabilities, and then secures the enterprise from internal and external threats compliant with Federal, State, and industry standard… more
- CVS Health (Richmond, VA)
- …education on ICD codes as appropriate + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + ... through mentoring and instruction. + Conducts process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS,… more
- Humana (Richmond, VA)
- …Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Begins to influence department's strategy. ... medical coding, analytics, health record security and privacy, HIPAA compliance , and data governance. + Hold at least one...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Cherry Bekaert (Virginia Beach, VA)
- …practice, we have an excellent opportunity for a **Senior Associate (Consumer Compliance )** to join our team providing internal audit, regulatory ... our clients with deep knowledge, expertise and approaches in Regulatory Compliance , Internal Audit, Enterprise Risk Management, Technology Risk Management,… more
- Capital One (Mclean, VA)
- …Certified Anti-Money Laundering Specialist (CAMS), Certified Fraud Examiner (CFE), Certified Internal Auditor (CIA), Certified Public Accountant (CPA), or ... innovation, and technology will only make you a better auditor . This will require leveraging the power of data...conduct risk management + 15+ years of experience in internal auditing, regulatory compliance , first or second… more
- Truist (Richmond, VA)
- …6. Appropriate professional certification, such as, but not limited to, Certified Internal Auditor , Certified Information Systems Auditor , or Certified ... to determine the adequacy of the design and operating effectiveness of internal controls. Ensure compliance with laws, regulations, and corporate policies.… more