- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding ... and communicate Key Performance Indicator(KPI) requirements as determined by the Medical Coding Auditor Manager + Participate in the development of coding and… more
- Commonwealth of Pennsylvania (PA)
- …(CFE) + Certified Government Audit Professional (CGAP) + Certified Government Financial Manager (CGFM) + Certified Internal Auditor (CIA) + Certified Information ... + CGAP (Certified Government Auditing Professional) + CGFM (Certified Government Financial Manager ) + CIA (Certified Internal Auditor ) + CISA (Certified… more
- Catholic Health Initiatives (Little Rock, AR)
- …all things quality and risk for the value hub. + Through Risk Management/ Auditor Manager , implements a risk adjustment coding department in appropriate Arkansas ... providers to improve documentation and coding practices, for accurate claims submissions and accurate reimbursement. + Continue to work...guidelines for these new processes. + Support the Risk Auditor Manager of closely working with the… more
- LA Care Health Plan (Los Angeles, CA)
- Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits...This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the… more
- Elevance Health (Roanoke, VA)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... Make an Extraordinary Impact.** **Title** : Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG) **Virtual: ** _ _ This role… more
- The County of Los Angeles (Los Angeles, CA)
- LAW ENFORCEMENT AUDITOR Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4668332) Apply LAW ENFORCEMENT AUDITOR Salary $109,807.68 - ... law enforcement operations. This classification acts as a project manager and is distinguished by its role in providing...No 10 In the execution of the Law Enforcement Auditor duties, you will have to make site visits… more
- City of New York (New York, NY)
- …daily claims reports and the monthly reports which detail claim associated fees to ensure compliance with contractual obligations, regulatory requirements, and ... requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. 2. Claims Data Validation: Verify the… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
- Elevance Health (San Juan, PR)
- …technology and business operations services for health plans. **Performance Quality Auditor I** **Location:** This role requires associates to be in-office [2] ... be necessary based on company needs. The **Performance Quality Auditor I** , responsible for evaluating the quality of...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more