• Claims Auditor I

    Elevance Health (Houston, TX)
    ** Claims Auditor I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... an accommodation is granted as required by law._ The ** Claims Auditor ** **I** is responsible for pre...claim including eligibility, system coding and pricing, pre-authorization, and medical necessity. + Contacts others to obtain any necessary… more
    Elevance Health (08/30/25)
    - Related Jobs

  • 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 (06/21/25)
    - Related Jobs

  • Claims Auditor (Remote)

    WTW (Dallas, TX)
    …a high level of claims administration knowledge, including experience with medical , dental, mental health and Medicare + Detailed knowledge of ICD-10 ... the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment… more
    WTW (08/23/25)
    - Related Jobs

  • DRG Coding Auditor

    Elevance Health (Houston, TX)
    …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
    Elevance Health (08/13/25)
    - Related Jobs

  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Grand Prairie, TX)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
    Elevance Health (08/09/25)
    - Related Jobs

  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
    Elevance Health (08/13/25)
    - Related Jobs

  • Clinical Provider Auditor II

    Elevance Health (Houston, TX)
    …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
    Elevance Health (08/26/25)
    - Related Jobs

  • Attorney Auditor

    Sedgwick (San Antonio, TX)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
    Sedgwick (07/09/25)
    - Related Jobs

  • 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 (08/08/25)
    - Related Jobs

  • Sr Compliance RCM & Coding Auditor

    Humana (Austin, TX)
    **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 (08/23/25)
    - Related Jobs