- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... and procedures. + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief...High School Education. + Minimum 3 years' experience in Healthcare Claims Processing role + Minimum 1… more
- Elevance Health (Overland Park, KS)
- ** Claims Auditor I** **Virtual:** This role...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with ... an accommodation is granted as required by law._ The ** Claims Auditor ** **I** is responsible for pre...a longstanding history in the healthcare industry, looking for leaders at all levels of… more
- Conduent (Dallas, TX)
- …pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against ... of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to… more
- Centene Corporation (Sacramento, CA)
- …Finance, Healthcare or equivalent experience preferred. + 2+ years claims compliance experience, preferably with State or Federal managed care programs required. ... PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective claims… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Adecco US, Inc. (Minneapolis, MN)
- …your foot in the door with a company that is driving ethical and responsible healthcare innovation. If Auditor sounds like something you would be interested in, ... RN preferred. + 3-5 years of experience in auditing, claims review, or compliance ( healthcare industry preferred)....+ Opportunity to work with a global leader in healthcare and program integrity This ** Auditor ** role… more
- Actalent (West Des Moines, IA)
- …requires auditing and pricing a wide variety of claim types and identifying claims requiring further review. The Nurse Auditor will also maintain productivity ... Job Title: Nurse Auditor Job Description We are seeking a highly...HCPCS. The successful candidate will be responsible for adjudicating claims , maintaining compliance with client contracts, and ensuring accuracy… more
- Robert Half Accountemps (Boston, MA)
- …a strong background in auditing, claims administration, and compliance within the healthcare sector. The ideal RN Auditor candidate will play a critical role ... Description We are looking for a highly skilled RN Auditor to join our team in Boston, Massachusetts. This...* Minimum of 3-5 years of experience in auditing, claims administration, or compliance within the healthcare … more
- HUB International (Chicago, IL)
- …a plus. Experience: A minimum of 3-5 years of experience in the PBM industry, healthcare claims auditing, or a related field. Direct experience with PBM audits ... success in mergers and acquisitions. **ABOUT THE ROLE** **Summary:** The PBM Auditor is responsible for conducting comprehensive audits of Pharmacy Benefit Managers… more