- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP- Claims ... (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment,... has working knowledge of the overall aspects of claim processing, both in and outside of Security Health… 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...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- Molina Healthcare (Iowa City, IA)
- …+ Experience independently reviewing and processing simple to moderately complex High dollar claims and knowledge of all claim types of reimbursements not ... RBRVS, FFS applicable for HD Inpatient, Outpatient and Professional claims . + 2+ years of comprehensive claim ...Professional claims . + 2+ years of comprehensive claim audits as preference + Knowledge of relevant CMS… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all...liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care delegates. Reviews and… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123 **Job Locations**… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities...perform onsite audits (1-4 times per month) + Evaluate claims and provider documentation for compliance and accuracy +… more
- UCLA Health (Los Angeles, CA)
- …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, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- UCLA Health (Los Angeles, CA)
- …You will be responsible for monthly random and focus audits of all claim processing activities to identify inaccurate claims adjudication. This will involve ... reviewing UB04 and CMS 1500 healthcare claims and adjustments for accuracy, and appropriate application ...resolutions, adjustments, appeals, and reopen guidelines * Understanding of Claim Adjustment Reasons and Remittance Advice Remark codes *… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure ... claims are processed in accordance with Federal, State and...results to recommend system or procedural changes to increase claim accuracy and/or identify opportunities for workflow enhancements. +… more
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