• Financial Compliance Auditor III…

    LA Care Health Plan (Los Angeles, CA)
    Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial… more
    LA Care Health Plan (04/05/25)
    - Related Jobs
  • Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... and procedures. + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (05/10/25)
    - Related Jobs
  • Pharmacy Claims Auditor CPhT

    Conduent (Orlando, FL)
    …pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against ... of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to… more
    Conduent (04/22/25)
    - Related Jobs
  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
    Centers Plan for Healthy Living (04/15/25)
    - Related Jobs
  • Nurse Auditor /Rev Intgty Spec

    Chesapeake Regional Healthcare (Chesapeake, VA)
    Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising the… more
    Chesapeake Regional Healthcare (04/05/25)
    - Related Jobs
  • Forensic Auditor : Investigate Complex…

    New York State Civil Service (New York, NY)
    NY HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Complex Healthcare Fraud (6383) Occupational Category Financial, ... Criminal Justice DivisionMedicaid Fraud Control Unit - New York CityForensic Accountant/ Auditor Reference No. MFCU_NYC_FAA_6383Salary is $66,964 + $3,400 in location… more
    New York State Civil Service (04/01/25)
    - Related Jobs
  • Forensic Auditor : Investigate…

    New York State Civil Service (Syracuse, NY)
    NY HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Healthcare Fraud (6390) Occupational Category Financial, Accounting, ... analysts, nurses, and legal support analysts to conduct complex, long-term healthcare fraud investigations.The Medicaid program provides health coverage to millions… more
    New York State Civil Service (05/17/25)
    - Related Jobs
  • Supv Coding Auditor & Educator

    Mohawk Valley Health System (Utica, NY)
    SUPV CODING AUDITOR & EDUCATOR Department: MEDICAL GROUP ADMINISTRATION Job Summary The Supervisor Coding Audit and Education is responsible for overseeing medical ... and education initiatives within the Medical Group. This role supervises Coding Auditor & Educators and conducts coding audits, ensuring adherence to national… more
    Mohawk Valley Health System (05/10/25)
    - Related Jobs
  • Inpatient DRG Quality Auditor

    Humana (Boise, ID)
    …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
    Humana (05/10/25)
    - Related Jobs
  • Compliance Auditor

    Addiction Recovery Care (Lexington, KY)
    …provision of care, proper documentation of services, and the billing and coding of claims . The Compliance Auditor assists the VP of Compliance and other ... way and has become one of the fastest growing healthcare systems in Kentucky (and beyond!) in addiction treatment,...of everything we do! We are hiring a Compliance Auditor for our growing team! The Compliance Auditor more
    Addiction Recovery Care (05/15/25)
    - Related Jobs