- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... + Maintains up-to-date working knowledge on regulatory requirements associated with billing and claims processing, as well as HIPAA guidelines/established Encryption… more
- Methodist Health System (Dallas, TX)
- …audits for areas of concern to assure documentation standards are being met for billing / coding purposes. **_Duty 4_** : Assist in training and education of ... for auditing and abstracting. **_Preferred_** : Certified Professional Medical Auditor (CPMA) certification from AAPC **_Experience/Knowledge_** : 2+ years...coders and staff on compliance billing and coding principles for government and… more
- Humana (Corpus Christi, TX)
- …accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor will help ensure all records meet federal, state, and payer-specific ... standards, reducing audit risk and financial exposure. The QA Auditor will review Start of Care (SOC), Recertification, and Discharge documentation for completeness… more
- Conduent (Charlotte, NC)
- …and overall accuracy. + Assessing payments against regulatory or administrative charges, coding , and billing errors to identify inaccuracies in billing ... a culture where individuality is noticed and valued every day. **Medical Review Auditor Analyst (Remote - Charlotte Area)** **Are you a strong, smart, talented,… more
- New York State Civil Service (Pearl River, NY)
- …HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Complex Healthcare Fraud, 6405 Occupational Category Financial, Accounting, ... Medicaid Fraud Control Unit - Pearl River (Rockland County)Forensic Accountant/ Auditor Reference No. MFCU_PR_FAA_6405Application Deadline is October 31, 2025Salary… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines ... and professional coding and billing audits. Duties/Responsibilities: Analysis of coding and billing data, identification of trends and aberrations.… more
- SSM Health (MO)
- …**Worker Type:** Regular **Job Highlights:** Exciting opportunity for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus. ... are found to be unsubstantiated through review of the medical record and/or billing information. Tracks assigned cases and enters data of audit related information… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and compliance functions necessary to effect accurate and complete ... DUTIES AND RESPONSIBILITIES + Ensures adherence to regulatory requirements related to billing and supporting documentation, as well as facilitates the completion of… more
- Baystate Health (Springfield, MA)
- …diversified duties in connection with reviews of medical record documentation for professional billing to ensure it meets the AMA and CMS (Medicare) guidelines for ... using MDAudit based on determined intervals per provider. Validates appropriate billing and documentation that complies with governmental and commercial carrier… more
- Rising Medical Solutions (Milwaukee, WI)
- …+ Being the best, not the biggest The Role: The Specialty Medical Bill Auditor will maximize savings for clients by accurately analyzing and processing medical bills ... law, fee schedules, usual and customary rates (UCR), current PPO contracts, coding and bundling guidelines, client instructions, claim history, and company policies… more