- Elevance Health (Mason, OH)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate… more
- MyFlorida (Miami, FL)
- TAX AUDITOR III - 79011031 Date: Sep 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 860412 Agency: Business and Professional Regulations Working Title: TAX AUDITOR III - 79011031 Pay Plan: Career Service Position Number: 79011031… more
- AutoZone, Inc. (Little Rock, AR)
- **Job Description** As a **Sr. Audit Recovery Auditor ** , you will Utilize analytical and forensic email review skills to audit Merchandising negotiations to recover ... 3rd Party vendors to recover less than 10% behind Senior Auditor . Negotiate and communicate flawlessly with Merchandising and Vendors to successfully… more
- Insight Global (South Jordan, UT)
- …with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims … more
- TEKsystems (Honolulu, HI)
- QNXT quality auditor reviews and tests the configuration and performance of the QNXT platform, a healthcare claims and benefits management system. The role is ... crucial for ensuring accurate claims processing, regulatory compliance, and overall system integrity. Key...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- TEKsystems (Honolulu, HI)
- Description Key Responsibilities + Claims Auditing: + Reviewing medical claims to verify accurate coding, correct benefit payments, and adherence to contract ... policies. + Issue Resolution: + Investigating and resolving discrepancies in claims payments and identifying underlying system or benefit inaccuracies. + Compliance… more
- Highmark Health (Helena, MT)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program for ... JOB DUTIES AND RESPONSIBILITIES: + Perform quality audits to include reviewing medical record documentation for completeness and accuracy to support billed claims… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors ... periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality control reviews, internal… more