- Elevance Health (Overland Park, KS)
- ** Claims Auditor I** **Virtual:** This role...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... an accommodation is granted as required by law._ The ** Claims Auditor ** **I** is responsible for pre...dollar claims while maintaining acceptable levels of claims inventory and age. + Ensures claim … 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...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123 **Job Locations**… 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 ... possibility of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief Administrative Officer. This position… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- Centene Corporation (Sacramento, CA)
- …PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective claims ... a monthly, quarterly and annual basis to ensure regulatory compliance. + Perform claims compliance audits for either federal or state programs. + Evaluate processes… more
- UCLA Health (Los Angeles, CA)
- …to the 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) for accuracy, appropriate application of benefits, authorization for services, contract… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...results to recommend system or procedural changes to increase claim accuracy and/or identify opportunities for workflow enhancements. +… more
- NTT DATA North America (Decatur, IL)
- …Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and ... including pre-determinations and retrospective reviews. + Review submissions by the Claims Department to determine appropriateness of services through established UM… more
- Commonwealth of Pennsylvania (PA)
- Revenue Tax Auditor Trainee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5057899) Apply Revenue Tax Auditor Trainee Salary $56,802.00 - ... of Revenue, Bureau of Audits, as a Revenue Tax Auditor Trainee. You will be trained to conduct field...Select the Level of Performance that best describes your claim . + A. I have experience writing technical, narrative,… more