- Cedars-Sinai (Los Angeles, CA)
- …America's Best Hospitals. **What you be doing in this role:** The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, ... the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with documentation, coding,… more
- UCLA Health (Los Angeles, CA)
- …Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor , MAPD, focused on Medicare Advantage (Part C) and Prescription ... role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... coding guidelines are met (eg, ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor 's work assignments are varied and frequently require interpretation and independent… more
- Humana (Sacramento, CA)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research, ... interpretation and application of laws and regulations. Charge Auditor evaluates the adequacy and effectiveness of internal and operational controls designed to… more
- Sharp HealthCare (San Diego, CA)
- …of CPT, ICD-10 and HCPCS codes is required. + Thorough understanding of Medicare , insurance documentation, and compliance and coding requirements. + Expert ... standards by clinical providers as established by SHC Corporate Compliance in accordance to the CMS and local MAC... in accordance to the CMS and local MAC ( Medicare Administrative Contractor) requirements. **Required Qualifications** + 3 Years… more
- Humana (Sacramento, CA)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural ... terminology and medical codes (eg, ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the… more
- UCLA Health (Los Angeles, CA)
- …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, and denied)...services, contract interpretation, Division of Financial Responsibility (DOFR), and application/ compliance with policies and procedures. You will: + Research… more
- US Tech Solutions (Whittier, CA)
- …date: Immediately** **Contract length: 3 months** **POSITION SUMMARY** The Claims Auditor assists in the Claims Department by analyzing procedures, policies and ... medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key skills by touch; excellent communication skills;… more
- Humana (Sacramento, CA)
- …Accountant, Certified Information Systems Auditor , or Certified Internal Auditor , Project Management certification, Healthcare Compliance Certification, etc. ... and help us put health first** Humana Healthy Horizons is hiring a Compliance Professional who will support efforts for overall Medicaid business by joining the… more