- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of ... all examiners assigned to the auditor . You will review claims (paid, pending,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief...medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term… more
- Conduent (Los Angeles, CA)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical...offer perks and rewards designed to support you:** + ** Health & Welfare Benefits:** Comprehensive plans tailored to your… more
- Insight Global (Los Angeles, CA)
- …person will be responsible for for conducting audits of claims processed by medical groups and health plans contracted with LA Care, focusing on regulatory ... Insight Global is looking for a Sr. Financial Compliance Auditor for one of the largest health ...(eg, MTR, OMT). Conduct oversight of delegates and subcontracted claims processors. We are a company committed to creating… more
- NTT DATA North America (Decatur, IL)
- …include medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, ... Summary:** The Utilization Management Coordinator reports to the Director of Claims . This position is responsible for coordinating the appeal activities and… more
- Henry Ford Health System (Troy, MI)
- …and managed care membership data. + Knowledge of industry claims , healthcare and medical terminology. + Proficient with health care claims data and ... to resolve identified issues on a case-by-case basis. The auditor will request medical records from providers...for fraud and abuse prevention and control. + Performs medical record audits including audit of claims ,… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III is responsible all...and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- …and experience + Certified Professional/ Medical Coder or Certified Professional Medical Auditor desired Experience- + Minimum three years of experience ... medical billing and collections including follow-up on unpaid claims , researching insurance claims issues, and appealing...with generous Paid Time Off, 10 paid holidays, affordable medical , dental, and vision options, Health Savings… more