• Provider Services Auditor

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program for ... medical record documentation for completeness and accuracy to support billed claims . + Generate provider reports through billing software. + Coordinates, schedules,… more
    St. Luke's University Health Network (09/04/25)
    - Related Jobs

  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... 011250 CCA- Claims Hiring for One Year Term **_This position...+ Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education (nice to have):** + Masters… more
    Commonwealth Care Alliance (11/25/25)
    - Related Jobs

  • Insurance Claims Specialist

    DoorDash (Tempe, AZ)
    …company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward ... DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more
    DoorDash (09/10/25)
    - Related Jobs

  • Quality Rev Cyc Billing Spec / PA Third Party…

    Hartford HealthCare (Farmington, CT)
    Work where*every moment*matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every ... matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work… more
    Hartford HealthCare (09/27/25)
    - Related Jobs

  • Certified Medical Coder

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    …and corresponds with insurance companies in an effort to obtain accurate reimbursement for healthcare claims . . Duties include but are not limited to: + Utilize ... companies and healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent with the industry… more
    Dallas Behavioral Healthcare Hospital (11/11/25)
    - Related Jobs

  • PRN - Medical Coder/Records Clerk

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    …research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, ... and healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent with the industry-standard… more
    Dallas Behavioral Healthcare Hospital (11/06/25)
    - Related Jobs

  • Market Director Population Health Quality and Risk

    Catholic Health Initiatives (Little Rock, AR)
    …all things quality and risk for the value hub. + Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and ... providers to improve documentation and coding practices, for accurate claims submissions and accurate reimbursement. + Continue to work...guidelines for these new processes. + Support the Risk Auditor Manager of closely working with the HCC Risk… more
    Catholic Health Initiatives (11/15/25)
    - Related Jobs

  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, ... + Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of… more
    Excellus BlueCross BlueShield (09/17/25)
    - Related Jobs

  • Internal Audit Manager - #Staff

    Johns Hopkins University (Baltimore, MD)
    …demonstrates subject matter expertise in operational internal auditing and the healthcare and/or higher education industry. Manages multiple complex internal audit ... + Represent department on assigned Institutional committees + Mentor and guide internal auditor staff in the execution of their assigned projects. + Demonstrate a… more
    Johns Hopkins University (11/04/25)
    - Related Jobs

  • Performance Quality Analyst I - CarelonRx

    Elevance Health (Indianapolis, IN)
    …billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector); or any combination of education and experience, ... Included are processes related to enrollment and billing and claims processing, as well as customer service written and...but are not limited to:** + Assists higher level auditor /lead on field work as assigned, including performing special… more
    Elevance Health (11/26/25)
    - Related Jobs