- Elevance Health (St. Louis, MO)
- ** Claims Auditor I** **Location :** This role...and post payment and adjudication audits of high dollar claims for limited lines of business, claim types ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… more
- 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
- Molina Healthcare (Iowa City, IA)
- …* Apply previous experience and knowledge to verify accuracy of updates to claim /encounter and/or system update(s) as necessary. * Works with fluctuating volumes ... updates/changes to member enrollment, provider contract, provider demographic information, claim processing guidelines and/or system configuration requirements.… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper category for benefit code...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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,...+ Computer proficiency with Microsoft Office + Knowledge of claims adjudication systems + Flexibility and adaptability… 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 ... on a key role within a world-class, award-winning health system . Ensure the efficient delivery of award-winning patient care....proficiency with Microsoft Word and Excel * Knowledge of claims adjudication systems (eg, EPIC-Tapestry, QNXT, IDX… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …including basic analysis of identified trends. + Analyzes audit results to recommend system or procedural changes to increase claim accuracy and/or identify ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- **OP Coding Auditor ** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Tennessee, Knoxville **Alternate Location(s):** ... ID:** J0925-0302 **Employment Type:** Full Time **Position Description:** The OP Coding Auditor is a member of the CGI Healthcare Compliance, Outpatient Coding Team,… more
- Prime Therapeutics (San Diego, CA)
- …procedures and objectives + Leverage professional pharmacy technician knowledge to validate claim documentation and systems data while onsite to ensure ... and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in Southern California) **Job Description** The Onsite Pharmacy Auditor… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Civil Service, Department of Title Internal Auditor 1, or Trainee 1 / Trainee 2 Occupational Category Other Professional Careers Salary Grade NS ... and enter member information into NYSHIP's databases. Under the direction of an Internal Auditor 2 the Internal Auditor 1, or Trainee 1 /Trainee 2's duties… more
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