- WTW (Houston, TX)
- **Description** As a Medical Claim Field Auditor , you will apply your medical claims audit, project management and claim processing and auditing ... environment + Claims processing knowledge/exposure to one or more administrator claim systems such as UNET, WGS, NASCO, ACAS, Proclaim, PowerMHS, Facets, ITS,… more
- WTW (Houston, TX)
- **Description** As a Medical Claim Lead Auditor , you will apply your audit, project management and client management skills to lead client audits. You will serve ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- US Tech Solutions (Whittier, CA)
- …: Day** **Next Start date: Immediately** **Contract length: 3 months** **POSITION SUMMARY** The Claims Auditor assists in the Claims Department by analyzing ... status and pending claims reports ensuring authorized claims are paid in accordance with company ...authorized claims are paid in accordance with company guidelines 6.Investigate, process and track payment adjustments including… more
- Cedars-Sinai (Los Angeles, CA)
- …fuels innovation. **Req ID** : 13340 **Working Title** : Outpatient Surgical and Claims Edit Auditor **Department** : CSRC Coding Audit **Business Entity** : ... Los Angeles. We also were awarded the Advisory Board Company 's Workplace of the Year. This award recognizes hospitals...will I be doing in this role?** The Coding Auditor works under the general direction of the Coding… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- UPMC (Pittsburgh, PA)
- …in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part of the… more
- Elevance Health (Chicago, IL)
- …methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company , for all lines of ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside… more
- Elevance Health (Ashburn, VA)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept… more
- Humana (Columbus, OH)
- …evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical...looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers… more
- AmeriHealth Caritas (Philadelphia, PA)
- …audit process and communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case is migrated appropriately. ... post-implementation review is completed as the policy outlines. The auditor will be expected to build/run complex queries to...will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all… more