- 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
- 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
- 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 (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 (Houston, 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 (Grand Prairie, TX)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The Clinical Provider Auditor II is responsible ... **Clinical Provider Auditor II** This role requires associates to be...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- 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
- 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
- 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
- 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