- Insight Global (South Jordan, UT)
- …valid claim identification and documentation (letter writing). Identifies potential claims outside of the concept where additional recoveries may be available. ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their… more
- Sharp HealthCare (San Diego, CA)
- …provides certificate; Other; Certified Health Care Compliance (CHC) - Compliance Certification Board **Hours** **:** **Shift Start Time:** Variable **Shift End ... and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's)… more
- Elevance Health (Atlanta, GA)
- **Clinical Provider Auditor I (CPC)** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... is granted as required by law.** The **Clinical Provider Auditor I (CPC)** is responsible for identifying issues and/or...abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Elevance Health (Norfolk, VA)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Elevance Health (MD)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Location: Must be located in Maryland.** This field-based role enables ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Rising Medical Solutions (Milwaukee, WI)
- …offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, Fortune 1000 ... + 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… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time position working ... Monday through Friday daylight hours and will be fully remote.. The Clinical Auditor /Analyst is an integral part of the Risk Adjustment Department and is responsible… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Tax Fraud Auditor ** **Job Class: Revenue Tax Specialist, Intermediate** **Agency: Revenue Department** + **Job ID** : 89315 + **Location** : St. ... may be used to fill multiple vacancies.** As an auditor on the fraud team, you will screen individual...tax refund, and withholding tax returns for potential fraudulent claims . You will independently perform audit examinations, research third… more
- 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
- Bozeman Health (Bozeman, MT)
- Position Summary: The Compliance Auditor supports an effective compliance program by planning and executing risk-based audits, monitoring adherence to federal and ... healthcare administration, business, accounting, or related field. + Professional certification (eg, Certified in Healthcare Compliance (CHC), Certified Professional… more