- 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: ... to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for various...Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT),… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit...Groups (PPG), Specialty Health Plans (SHP) and Pharmacy Benefit Manager (PBM) including LA Care's Claims Department.… more
- Elevance Health (Chicago, IL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- Elevance Health (Tampa, FL)
- …using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the findings ... **Provider Auditor ** _This position will work a hybrid model...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- Saint-Gobain (Jonesburg, MO)
- …Production + Member of American Society of Quality + ASQ Certificate as Engineer, Auditor , or Manager + Ability to develop and implement quality programs, ... ensure finished goods conform to specified requirements. + Manages the customer claims resolution and corrective action system. + Creates local documentation, such… more
- Catholic Health Initiatives (Chattanooga, TN)
- **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an emphasis on ... met at the highest level. The Sr Coding Compliance Auditor 's primary focus will be to facilitate and ensure...other portion of time focused on provider communication, and claims denial resolutions. Communicates denial trends to leadership and… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …Boars Head Brand. Complete special projects as assigned by the Sr. QA Manager . Job Description: Essential Duties and Responsibilities + Provide advanced super user ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...able to attend a training course. + Serve Safe Manager Certification or be able to attend a training… more
- Elevance Health (South Portland, ME)
- **Clinical Provider Auditor II** _Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will live ... recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Provider Auditor II is responsible for identifying issues and/or entities that may… more
- Elevance Health (Hanover, MD)
- **Clinical Provider Auditor Senior** **Supports Payment Integrity line of business** _Lo_ _cation: This is a field position expected to be in clinic 60% of the time ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor Senior** is responsible for identifying issues and/or entities that… more