- Ventura County (Ventura, CA)
- …analyze (Accountant I) or calculates and analyzes (Accountant II) Incurred but not Reported medical claims based on system generated claim lag reports to provide ... flexible credit allowance of up to $23,530 annually to offset the purchase of medical , dental, and/or vision insurance for you and your dependents. + Employee only -… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure ... or their respective auditors JOB DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code… more
- CVS Health (Scottsdale, AZ)
- … submitted through the CVS Health claims processing systems. The Pharmacy Claims Auditor will identify and rectify claim inaccuracies that would result in ... stay well in body, mind and spirit. The Pharmacy Claims Reviewer is responsible for reviewing pharmacy claims...correction. We offer a comprehensive benefits package which includes medical , dental, vision insurance as well as a wide-ranging… more
- CVS Health (Springfield, IL)
- …This candidate must reside in Illinois or Florida. As a Regional Pharmacy Onsite Auditor , you will be an essential part to the Pharmacy Audit Department at ... role, you will be based from your home and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing prescription claims … more
- Iowa Department of Administrative Services (Des Moines, IA)
- …and resolve all claims that have been identified by the DPS pre- auditor . + Facilitate the disability process for the POR Board of Trustees, POR members ... adherence to federal laws in regard to handling of medical records. Manage the request and review of ...Iowa's CAFR. Coordinate annual audit of program by the Auditor of State of Iowa. + Perform functions for… more
- The City of Rochester, MN (Rochester, MN)
- …properly record the capitalization of the land and building assets. Destination Medical Center Corporation (DMCC) + Review and verify accuracy of Master Applications ... preferably JD Edwards. Certifications Certified Public Accountant (CPA), Certified Internal Auditor (CIA), or Certified Management Accountant (CMA). If this work… more
- AmeriHealth Caritas (Newtown Square, PA)
- …organization. ; The manager must have the ability to determine correct coding, review claims , medical records and billing data from all types of healthcare ... performance goals. + Proactively identify and analyze patters or anomalies in pharmacy claims and operations indicative of fraud, waste and abuse.; + Lead and manage… more
- UGI Corporation (King Of Prussia, PA)
- …employees enjoy: Generous and Family-friendly Health & Welfare Benefits Including: * Medical , Vision, and Dental Plans * Optional Health Savings Account * Optional ... records and assist with drafting corporate resolutions and secretary's certificates. Handle auditor request letters. + Real Estate: Assist on right of way reviews,… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …a related field from an accredited university. Licenses/Certifications Preferred:Certified Professional Medical Auditor ( CPMA ), Certified Professional Coder ( ... laws and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance… more
- The County of Los Angeles (Los Angeles, CA)
- …(CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In ... addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency response system, as well as… more