- Elevance Health (Roanoke, VA)
- ** Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** _Location:_ **Virtual:** This role enables associates to work ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II ** is responsible for… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor II Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: July 31, 2025 Apply with Linkedin Apply Department of ... to its staff. ABOUT THE POSITION: As a Staff Auditor II you will: + Perform independent...and standards. + Analyze budget and expenditure information and/or clinical and professional records in a forensic capacity requiring… more
- Highmark Health (Harrisburg, PA)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system...+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and… more
- Corewell Health (Royal Oak, MI)
- …accuracy and potential interactions, accurately prepare and dispense medications, provide evidence-based drug information, monitor drug levels to optimize therapy, ... center with Level I adult trauma (https://www.beaumont.org/services/emergency/trauma) and Level II pediatric trauma (https://www.beaumont.org/services/childrens/specialties/pediatric-trauma) designations. Corewell Health William Beaumont… more
- Terumo Medical Corporation (Elkton, MD)
- Quality Engineer II Date: Jul 15, 2025 Req ID: 4925 Location: Elkton, MD, US Company: Terumo Medical Corporation Department: Quality Engineering Operations Terumo ... products, training and education programs that drive clear economic value, better clinical outcomes and improved quality of life for patients. TMC is part… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... program, procedure, budget, or personnel. - OR - Option II : Two (2) years of highly responsible administrative or...Assistant III**, Assistant Hospital Administrator I , Contract Program Auditor , or higher. YouMUSTmeet one of the above… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... control systems. Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the preparation of reports to support… more
- The County of Los Angeles (Los Angeles, CA)
- …of Intermediate Accountant- Auditor , Accountant III or higher. PHYSICAL CLASS II - Light: This class includes administrative and clerical positions requiring a ... in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- Wolters Kluwer (Chicago, IL)
- …action (CAPA)plans, with oversight of complaint trending, post-market surveillance, clinical evaluation, design control, and risk management activities. You will ... also work cross functionally within the business teams in Legal, Regulatory, Clinical , Marketing, and Product Development and within the broader Wolters Kluwer… more
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