- UCLA Health (Los Angeles, CA)
- …Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor , MAPD, focused on Medicare Advantage (Part C) and Prescription Drug ... role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with… more
- Capital One (New York, NY)
- Principal Auditor - Cyber, Risk and Analysis Technology Audit Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality ... Capital One is seeking an energetic, self-motivated Principal Technology Auditor with experience evaluating and analyzing technology and cybersecurity risks… 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 ... and diagnosis coding for services rendered is complete, compliant and accurate...compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require… more
- Catholic Health (Kenmore, NY)
- …8-4 Summary: The Catholic Health (CH) Health Information Management (HIM) Educator/ Auditor is responsible for providing Provider Coding education, including ... CHS/Trinity-employed providers appropriate code the medical services that are provided. The Educator/ Auditor will introduce new providers to the coding program… more
- Insight Global (Plano, TX)
- …Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity ... accurately reflect the patient's clinical picture. Utilize ICD-10-CM and ICD-10-PCS coding systems to ensure proper code sequencing and accuracy. Validate Present… more
- SUNY Upstate Medical University (Syracuse, NY)
- …trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding , and billing guidelines. ... Job Summary: Position Summary: Under the direction of the Compliance Officer the main duties for this position include:...main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or… more
- WMCHealth (Valhalla, NY)
- … System (HCPCS) and identifying opportunities for improvement as well as assuring compliance with coding and documentation guidelines. In addition the coder is ... Network Practice Coder/ Auditor Company: NorthEast Provider Solutions Inc. City/State: Valhalla,...Responsibilities: + Using the current HCPCS, ICD and CPT coding guidelines, audits medical records for coding … more
- St. Luke's University Health Network (Allentown, PA)
- …Services Auditor performs audits as part of the Documentation and Coding Compliance Program for professional services billed by providers employed with ... doing so, works with providers and their office staff, as well as the Coding and SLPG Billing Department. JOB DUTIES AND RESPONSIBILITIES: + Perform quality audits… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research, ... interpretation and application of laws and regulations. Charge Auditor evaluates the adequacy and effectiveness of internal and operational controls designed to… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... Start Date: December 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state… more