- Elevance Health (St. Louis, MO)
- ** Claims Auditor I** **Location :** This role...and post payment and adjudication audits of high dollar claims for limited lines of business, claim types ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… more
- Conduent (Los Angeles, CA)
- …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
- TEKsystems (San Bernardino, CA)
- The Collector 1 performs telephone calls and website checks for claim status from insurance companies, government payers, third party payers, worker's compensation ... with the terms and conditions of each contract and/or insurance company policies. Determines if payer needs additional information, identifies barriers, and… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123… 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
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Tennessee, Knoxville **Alternate Location(s):** ... ID:** J0925-0302 **Employment Type:** Full Time **Position Description:** The OP Coding Auditor is a member of the CGI Healthcare Compliance, Outpatient Coding Team,… more
- Prime Therapeutics (San Diego, CA)
- …and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in Southern California) **Job Description** The Onsite Pharmacy Auditor ... pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting… more
- Actalent (West Des Moines, IA)
- …auditing and pricing a wide variety of claim types and identifying claims requiring further review. The Nurse Auditor will also maintain productivity goals, ... Job Title: Nurse Auditor Job Description We are seeking a highly...procedures. + Audit and price a diverse range of claim types. + Identify claims with inaccurate… more
- Actalent (West Des Moines, IA)
- …wide variety of claim types, and ensuring compliance with departmental and company policies. Responsibilities + Adjudicate claims to maintain and comply with ... medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to...procedures. + Audit and price a wide variety of claim types. + Identify claims with inaccurate… more
- Elevance Health (Richmond, VA)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more