- Hartford HealthCare (Hartford, CT)
- …invite you to become part of Connecticut's most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of ... clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance … more
- MedKoder (Mandeville, LA)
- …services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer ... work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty… more
- Humana (Phoenix, AZ)
- …about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and ... validate the mitigation of compliance risk across the organization. This team ensures that...revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, and… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Customer Service Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting and… more
- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description We are seeking a highly skilled Nurse Auditor who can understand the intricacies of standard medical coding, including ... The successful candidate will be responsible for adjudicating claims, maintaining compliance with client contracts, and ensuring accuracy in payment criteria. This… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor I Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: Sept. 5, 2025 Apply with Linkedin Apply Department of Health ... to its staff. ABOUT THE POSITION: As a Staff Auditor I you will: + Perform professional audit work...funds through contracts with DHHS. + Complete financial and/or compliance audits for conformance to established laws, rules, regulations… more
- YAI (Manhattan, NY)
- …Key/Essential Functions & Responsibilities + Implements the organization's compliance program under the supervision of the Assistant Director ... of Corporate Compliance and in coordination with program staff. + Maintains...(Office for People with Developmental Disabilities (OPWDD), Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector… more
- Baystate Health (Springfield, MA)
- …documentation for professional billing to ensure it meets the AMA and CMS ( Medicare ) guidelines for the services billed, reviewing and validating billed charges and ... interacts with employees at all levels. The incumbent has an understanding of compliance audit concepts. This includes but is not limited to relaying confidential… more
- Atlantic Health System (Morristown, NJ)
- …assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... + Audit charts for accurate and correct coding and compliance within documentation guidelines and AHS policies + Prepares...and billing department + Provides clarification on coding and compliance policies Required: * CPC Certification * Minimum 6… more