• Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …Take your 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,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… more
    UCLA Health (05/08/25)
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  • Pharmacy Claims Auditor CPhT

    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...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
    Conduent (06/21/25)
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  • Financial Compliance Auditor

    Insight Global (Los Angeles, CA)
    …person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, focusing on regulatory ... Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health ...(eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating… more
    Insight Global (07/26/25)
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  • Specialty Health Plans Auditor III

    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 ... required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all...and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans… more
    LA Care Health Plan (07/06/25)
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  • Diagnosis Related Group Clinical Validation…

    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
    Elevance Health (08/01/25)
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  • Law Enforcement Auditor

    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 - ... choose among a variety of pre-tax and after-tax benefits that include Medical and Dental coverage, Group life insurance, Accidental Death and Dismemberment… more
    The County of Los Angeles (08/04/25)
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  • Inpatient DRG Quality Auditor

    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, ... part of our caring community and help us put health first** In this role, you will conduct quality...This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from… more
    Humana (07/25/25)
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  • Compliance Coding Auditor

    Sharp HealthCare (San Diego, CA)
    …Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Health Care Compliance (CHC) - Compliance Certification Board; Certified Clinical Documentation ... and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's)… more
    Sharp HealthCare (07/13/25)
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  • Coding Auditor Educator

    Highmark Health (Sacramento, CA)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs...internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of… more
    Highmark Health (05/09/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Sacramento, CA)
    **Become a part of our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently ... cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must… more
    Humana (07/29/25)
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