- RTX Corporation (Hartford, CT)
- …with US Customs regulations. + Knowledge of non-US Customs regulations. + Certified Internal Auditor or other like certification is a plus. + Six Sigma, Ace, ... **What You Will Do:** + Support valuation reconciliation. + Support drawback claims . + Support post summary corrections. + Support resolution of problematic imports… more
- Commonwealth Care Alliance (Boston, MA)
- … claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies ... 011250 CCA- Claims Hiring for One Year Term **_This position...to have the one or all of the required certification OR willing to get certified within 1 year… more
- University of Rochester (Rochester, NY)
- …Ethics Professional (CCEP), + Certified Fraud Examiner (CFE), + Certified Internal Auditor (CIA), + Or equivalent professional certification **Knowledge, Skills ... OIC leadership to determine corrective action, such as formal self-disclosures or claim adjustments + Assists in responding to external audits and government… more
- The County of Los Angeles (Los Angeles, CA)
- …class of Administrative Assistant III, Assistant Hospital Administrator I, Contract Program Auditor , or higher. Option III: One year of responsible *staff experience ... complete this questionnaire completely, correctly, and accurately. The experience you claim in this supplemental questionnaire must be consistent with experience… more
- Rush University Medical Center (Chicago, IL)
- …each case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Exemplifies… more
- Hartford HealthCare (Farmington, CT)
- …the system.*__* *_Position Summary:_* The Quality Revenue Cycle Billing and Auditor Specialist is responsible for ensuring accuracy, compliance, compliance and ... efficiency withing the billing office. The auditor will implement and maintain an audit and education...for internal or external audits related to billing and claims . Research payer policies from in and out of… more
- CVS Health (Phoenix, AZ)
- …part of CVS Caremark's extensive Pharmacy Audit division. The Medicare Pharmacy Claims Auditor will administer assigned Medicare Part-D Compliance Audit ... Programs, review pharmacy submitted Medicare claims , make independent decisions, and call network pharmacies to audit submitted information and communicate business… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …compensation, property, and casualty exposures. ORM is also responsible for managing all tort claims made against the state or any of its agencies, whether or not ... of Federal Regulations. ORM contracts with a third party administrator to provide claims adjusting and loss prevention services, however ORM retains its authority to… more
- Covenant Health Inc. (Knoxville, TN)
- …Analyzes all correspondence regarding insurance denials for the revenue integrity auditor to take appropriate action. Prepares necessary documentation for insurance ... appeals process, ensuring timely follow through. Processes claim adjustments for leadership approval and posts payments as necessary. Maintains integrity of denials… more
- The County of Los Angeles (Los Angeles, CA)
- …requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more