- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- 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 ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… more
- Insight Global (Los Angeles, CA)
- …systems in the country. This person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, ... quarterly reporting (eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating inclusive environments… 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 - ... a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… 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 ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all aspects of planning, execution, reporting and corrective… more
- Humana (Sacramento, CA)
- …Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, ... materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from … more
- Elevance Health (Walnut Creek, CA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… 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)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… 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