- Elevance Health (Des Moines, IA)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
- 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