• Specialty Health Plans Claims

    LA Care Health Plan (Los Angeles, CA)
    Specialty Health Plans Claims Auditor ...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer ... to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit...planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health more
    LA Care Health Plan (02/24/25)
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  • Financial Compliance Auditor III…

    LA Care Health Plan (Los Angeles, CA)
    …tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA Care. This role works ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance...audit results. Perform claims audits for all medical groups and health plans contracted with… more
    LA Care Health Plan (04/05/25)
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  • Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (05/10/25)
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  • Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …Take your career 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,...GED or equivalent + Four or more years of medical claims payment experience in an HMO… more
    UCLA Health (05/08/25)
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  • Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …your career in an exciting new direction. You can do all this and more at UCLA Health . The Claims Quality Auditor serves as the primary point of contact for ... or equivalent experience required + Minimum of 4 years medical claims payment experience in an HMO...Microsoft Word and Excel. + Good working knowledge of claims adjudication systems. UCLA Health welcomes all… more
    UCLA Health (04/26/25)
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  • Pharmacy Claims Auditor CPhT

    Conduent (Chicago, IL)
    …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...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
    Conduent (04/18/25)
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  • Clinical Provider Auditor I - Maryland…

    Elevance Health (Hanover, MD)
    **Clinical Provider Auditor I** **Supports Payment Integrity & Behavioral Health ** _Location:_ This field-based role enables associates to primarily operate in ... medical -expense spending. A proud member of the Elevance Health family of companies, Carelon Behavioral Health ,...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
    Elevance Health (05/07/25)
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  • Clinical Provider Auditor Senior - Maryland…

    Elevance Health (MD)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor Senior** is responsible ... **Clinical Provider Auditor Senior** **Supports Payment Integrity line of business**...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
    Elevance Health (04/26/25)
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  • Auditor 1, SG-18, Auditor Trainee 2,…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency State Comptroller, Office of the Title Auditor 1, SG-18, Auditor Trainee 2, (Equated to SG-16), Auditor Trainee 1, (Equated to ... various tests, reviews, reconciliations, analyses and evaluations of accounts, claims , records, and procedures.o Assists in ongoing audit/examination strategy and… more
    New York State Civil Service (04/26/25)
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  • Coding Auditor & Educator - Full time…

    Mohawk Valley Health System (Utica, NY)
    …(CCS-P), or additional specialty certifications (eg, CPMA (Certified Professional Medical Auditor ). Disclaimer Qualified applicants will receive consideration ... Department: MEDICAL GROUP ADMINISTRATION Job Summary The Medical Group Coding Auditor and Educator is...Core Job Responsibilities + Perform thorough reviews of coded claims , ensuring compliance with ICD-10, CPT, HCPCS, HIPAA, HITECH… more
    Mohawk Valley Health System (05/19/25)
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