• Ambulatory Pharmacy Financial Analyst

    UCLA Health (Los Angeles, CA)
    …thinking and problem solving. You will assist with AR reconciliation, insurance contracting, audit of weekly claims exceptions etc. In a fast-paced and high ... intensity environment, you must be able to complete work independently on problems that may not have precedent and/or structure. At UCLA Health, our passion for leveraging state-of-the-art technology to support world-class patient care has enabled us to become… more
    UCLA Health (04/23/25)
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  • Paragould Transportation Specialist

    Prysmian Group (Paragould, AR)
    …inquiries from customer service reps about shipment tracking, carrier availability and use, claims order management and rates quotes. + Audit freight bills and ... resources to provide Corrective Action Response (CAR). + File claims for applicable shortages and damages, and update claim...details. + Officially file and process loss & damage claims with NA Transportation team. + Monitor claim progress… more
    Prysmian Group (05/24/25)
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  • Fraud and Waste Investigator

    Humana (Tallahassee, FL)
    …(Medical Coding or Healthcare (Medical Chart Review/Insurance Billing) or Internal/External Audit or Regulatory/Compliance OR Claims Investigations or Criminal ... ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and… more
    Humana (06/06/25)
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  • Claim Governance and Control Lead

    AIG (Atlanta, GA)
    …Management (ERM), Internal Audit Group (IAG), Compliance, External Auditors and the Claims organization. How you will create an impact + Drive a strong control ... your specialist expertise and experience. Make your mark in Claims . Our Claims teams are the proven...ensure necessary changes to controls are made based upon audit feedback (self-audits, internal audits, PwC audits). + Drive… more
    AIG (05/19/25)
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  • US Customs Manager

    Cisco (Research Triangle Park, NC)
    … * Support various US operational processes * Ensure timely and accurate claims through coordination with service providers * Audit results, prepare ... presentations, and communicate findings clearly * Engage in data-driven discussions and explain variances to management * Collaborate with teams and Data Scientists to gather and analyze key data * Your role will be crucial in enhancing our initiatives and… more
    Cisco (05/19/25)
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  • Senior Litigation Analyst

    The Hartford (Naperville, IL)
    …be determined.* Facilitate gathering and exchange of information with Claims regardingobserved and identified billing issues.* Identify opportunities warranting ... further investigation through discussionwith Claims and law firms, properly escalating observations internally aswell...review of the bill by the field handlerthrough final audit at the appeal level.* Support Claim reorganization and… more
    The Hartford (06/06/25)
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  • Quality Assurance Analyst

    Highmark Health (Buffalo, NY)
    …Guarantees and other operational quality process improvement efforts. Maintains accurate audit documentation and is required to follow appropriate audit ... within the process being audited. Manage individual inventory of audit work to meet department quality standards. Participate in...or more of the following) + 3 years in Claims Support and Processing + 3 years in Customer… more
    Highmark Health (05/23/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Indianapolis, IN)
    …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
    Elevance Health (06/04/25)
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  • Chief Auditor - Zurich Cover-More

    Zurich NA (New York, NY)
    Chief Auditor - Zurich Cover-More 123124 **About Us** **Zurich Group Audit ** Zurich Group Audit is a diverse international team of over 250 colleagues from 33 ... has a global remit and will be responsible for assessing and executing audit activities related to the global integration as well as designing and implementing… more
    Zurich NA (06/05/25)
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  • Law Enforcement Auditor

    The County of Los Angeles (Los Angeles, CA)
    …records, and other related areas, and prepares comprehensive reports on audit findings. CLASSIFICATION STANDARDS Positions allocable to this class are located ... professional standards. Incumbents must have extensive knowledge of performance audit standards, including Generally Accepted Auditing Standards and have familiarity… more
    The County of Los Angeles (05/05/25)
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