- Novo Nordisk Inc. (Plainsboro, NJ)
- …with global auditors and NNI employees to assist with the execution of the audit and follow-up on any remediation actions Reviews and analyses high risk activities, ... knowledge and clear understanding of the Anti-Kickback Statute and False Claims Act, FDA rules and regulations regarding the promotion of pharmaceuticals,… more
- TEKsystems (Springfield, MO)
- …will help them in this role. Skills Claims , RxClaims, Pharmacy benefits, Health insurance, Claims Analyst, Audit , support, analysis, workflow, claim, ... Healthcare, Medical Terminology Top Skills Details Claims ,RxClaims,Pharmacy benefits, Health insurance, Claims Analyst, Audit ,support,analysis Additional… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...at LogixHealth: We offer a comprehensive benefits package including health , dental and vision, 401(k), PTO, paid holidays, life… more
- DXC Technology (Richmond, VA)
- …quality control and assurance tasks, by reviewing Life and Annuity Death Claims payment and correspondence review, to ensure product compliance with regulatory and ... work experience in Life and Annuity** Proven experience in Life/Annuity Death Claims processing and Quality review** Proficiencies in quality assurance and risk… more
- LA Care Health Plan (Los Angeles, CA)
- …for planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health plans. These audits ... Senior Health Care Audit Analyst Job Category:...also LA Care contractual agreements. The position handles DMHC claims data submissions for LA Care and its Plan… more
- LA Care Health Plan (Los Angeles, CA)
- …for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA Care. ... findings that would affect the audit results. Perform claims audits for all medical groups and health plans contracted with LA Care. Timely audit reports… more
- Elevance Health (Houston, TX)
- **External Audit Facilitator** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while ... a dynamic and adaptable workplace. Alternate locations may be considered. The **External Audit Facilitator** is responsible for managing the process for claims … more
- CenterLight Health System (NY)
- …effectiveness of the claims department by timely and accurate processing of claims appeals and performing claims audit , ensuring payment integrity and ... monies and proper application of transaction by our TPA. + Perform in-depth claims audit to confirm that all medical claims paid and denied accurately.… more
- Novant Health (NC)
- …of ICD-10- CM/PCS, CPT or HCPCS codes and the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. + Audits ... audits, commercial payers, and CMS payers. Responses will be coordinated through the Audit Response Lead for all applicable Novant Health facilities.The Coding … more
- Novant Health (NC)
- …of ICD-10- CM/PCS, CPT or HCPCS codes and the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. + Audits ... audits, commercial payers, and CMS payers. Responses will be coordinated through the Audit Response Lead for all applicable Novant Health facilities.The Coding … more
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