- Conduent, Inc. (Los Angeles, CA)
- Job Description Pharmacy Claims Auditor CPhT Do you have a CPhT certification? Would you like to audit pharmacy claims for accuracy? About the Role Conduent ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… more
- UC Health (Cincinnati, OH)
- …Minimum Required: Bachelors Degree - Healthcare. Preferred: Masters Degree. | Professional Medical Auditor (CPMA) or an equivalent certification preferred. | ... equitable and diverse place of employment. The Charge Master Auditor is responsible for executing charge related audits. They...a variety of issues relating to charge capture. Edit claims (DNB, Claim Edits, and Stop Bills) within scope… more
- UnitedHealth Group (Minneapolis, MN)
- …Caring. Connecting. Growing together . In this position as a DRG CVA RN Auditor , you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement ... Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims . Employing both industry and Optum proprietary tools, you will validate ICD-10… more
- Optum (San Juan, PR)
- …Professional Coder (CPC) + CPC A Certified Inpatient Coder (CIC) Certified Outpatient Auditor (COC) Certified Professional Medical Auditor (CPMA) Certified ... will be required for this position) Preferred Qualifications: Experience working with medical claims platforms Medical record coding experience with… more
- CHS (Clearwater, FL)
- …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- NTT DATA North America (Decatur, IL)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote position. 100% Remote, Client ... of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief...nature of the role offered. Company benefits may include medical , dental, and vision insurance, flexible spending or health… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- Conduent (Alexandria, VA)
- …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor /Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... behalf of major healthcare payers. As a **Pharmacist - Claims Auditor /Reviewer** , you'll apply your clinical...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… 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...sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service… more
- WTW (Chicago, IL)
- …PPO, Indemnity and Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical , dental, mental health and ... **Description** As a Lead Auditor you will apply your audit, project management...will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report.… more
