- Healthfirst (FL)
- …in Healthcare /Health Plan customer service, operations, vendor management, or claims processing. + Previous work experience in an auditing function conducting ... understanding of healthcare Operations processes and supporting systems such as Claims Processing, Enrollment & Billing, and Member Services. + Knowledge of at… more
- Elevance Health (Winston Salem, NC)
- …diploma or GED and a minimum of 4 years related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of ... ** Claims Auditor Senior** **Location :** This role enables...necessary information. + Completes and maintains detailed documentation of audit which includes decision methodology, system or processing errors,… more
- Insight Global (Nashville, TN)
- …and ICD10 codes, UB04s and HCFA Forms . Strong knowledge of Physician and Facility Claims , Audit Codes and Billing, DRGs and ICD-10, Appeals Processes . . Proven ... state correctional facilities, government contracts -Background in non-commercial insurance claims (eg, government-funded programs, correctional healthcare , etc.).… more
- Cardinal Health (San Juan, PR)
- …E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles and techniques; CMS ... with other documentation and coding and billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, and… more
- Conduent (Los Angeles, CA)
- … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... performs in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims ...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
- Point32Health (Canton, MA)
- …who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of ... (minimum years required): + Required (minimum): 5-7 years of related professional healthcare experience including familiarity with medical claims processing. +… more
- DoorDash (Tempe, AZ)
- …company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward ... cross-functional partners at DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's Corporate Risk & Insurance… more
- Kelly Services (Glastonbury, CT)
- … claims processing certification required** **If you're passionate about healthcare administration and providing excellent support to patients and providers, we ... **Job Title:** **Bilingual** Medical Claims Processor / Medical Claims Specialist...accurate financial records and assist with batch processing + Audit outgoing payments for accuracy and compliance + Manage… more
- Elevance Health (Chicago, IL)
- …leading Claims Operations teams and strategy within a large healthcare payor environment strongly preferred. + Proven track record leading Digital Transformation ... **Director II Digital Claims Operations (Dir II Digital Ops)** Location: This...Benefits Administration, Provider Engagement and Contracting, Sales and Internal Audit . + Hires, trains coaches, counsels, and evaluates performance… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Claims Auditor **Cost Center:** 682891379 SHP- Claims **Scheduled Weekly Hours:** 40 ... shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround… more