• Pharmacy Claims Auditor CPhT

    Conduent (Dallas, TX)
    …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 (05/31/25)
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  • DRG Coding Auditor

    Elevance Health (Grand Prairie, TX)
    …considered._ The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
    Elevance Health (05/29/25)
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  • Attorney Auditor

    Sedgwick (Dallas, TX)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of our clients for… more
    Sedgwick (04/09/25)
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  • Inpatient DRG Quality Auditor

    Humana (Austin, TX)
    …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 (05/30/25)
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  • Coding Auditor Educator

    Highmark Health (Austin, TX)
    …(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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  • External Audit Facilitator

    Elevance Health (Houston, TX)
    …and audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded ... Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits,… more
    Elevance Health (05/23/25)
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  • Compliance Coding And Billing Analyst

    University of Texas Rio Grande Valley (Mcallen, TX)
    …a related field from an accredited university. Licenses/Certifications Preferred:Certified Professional Medical Auditor ( CPMA ), Certified Professional Coder ( ... federal/state laws and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness,… more
    University of Texas Rio Grande Valley (05/09/25)
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  • Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    …(RN) will be required after 6 months of employment. Preferred: Certified Professional Medical Auditor ( CPMA ) from American Academy Professional Coders ( ... billing/collection staff to ensure accurate physician reimbursement is achieved and claims denials are reduced by ensuring documentation integrity. * Educates all… more
    University of Texas Rio Grande Valley (04/28/25)
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