- The Cigna Group (Bloomfield, CT)
- …for pharmacy audits up to 50% of the time. **POSITION SUMMARY:** The Quality Review and Pharmacy Technician Audit Lead Analyst is responsible to identify pharmacy ... knowledge needed to interpret audit scope. As a Staff Auditor , this position may act as a resource for...informed, objective assessment of the accuracy and legitimacy of claims audited. + Utilize personal knowledge of medications and… more
- The Diez Group (Dearborn, MI)
- Quality Engineer Dearborn, MI (http://maps.google.com/maps?q=8111+Tireman+Ave+Dearborn+MI+USA+48126) Description Summary/Objective April Steel Processing, is ... currently seeking an individual who is passionate about quality improvement in manufacturing environments with knowledge of ISO...from the steel mills . Process monthly R1 Mill Claims . Monitors status of rejected/hold material in Hold… more
- State of Minnesota (Vadnais Heights, MN)
- **Working Title: DCT Revenue Cycle Quality Assurance Analyst** **Job Class: Management Analyst 4** **Agency: Direct Care and Treatment** + **Job ID** : 87792 + ... essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of...the revenue cycle, including billing, coding, insurance verification, and claims processing. The goal is to identify areas of… more
- Ventura County (Ventura, CA)
- …Management staff, CEO Budget and Finance, GSA Procurement, and the Auditor Controller's Accounts Payable, Financial Planning, and Financial Reporting staff. ... organizations/departments regarding fiscal issues and policies. + Assists the Auditor -Controller's Office/State Controller's Office with the preparation of financial… more
- Ventura County (Ventura, CA)
- …National Recreation Area. Ventura County's beauty and weather combined with a wonderful quality of life are among the many reasons our residents choose to call ... on schedule; prepares quarterly status reports; calculates allocation to the Auditor -Controller for fund accounting purposes; maintains accounting records for audit… more
- The City of Rochester, MN (Rochester, MN)
- …the submission of timely and accurate financial data, while maintaining quality internal controls; provide direction to staff regarding questions on accounting ... the Public Library, and recommend any programming changes needed to ensure quality internal controls. + Provide guidance and direction for various accounting… more
- CVS Health (Scottsdale, AZ)
- … submitted through the CVS Health claims processing systems. The Pharmacy Claims Auditor will identify and rectify claim inaccuracies that would result in ... pioneering a bold new approach to total health. Making quality care more affordable, accessible, simply and seamless, to...stay well in body, mind and spirit. The Pharmacy Claims Reviewer is responsible for reviewing pharmacy claims… more
- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure ... payers. Meet or exceed established benchmarks for productivity while maintaining quality . + Identify and provide feedback, including identification of trends, to… 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 ... organizational skills. **Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications * Experience working… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with ... needed. + Collaborates with the medical billing team to improve the quality of clinical documentation for compliance, billing, coding, and reimbursement processes. +… more