- CVS Health (Phoenix, AZ)
- …team of auditors as part of CVS Caremark's extensive Pharmacy Audit division. The Medicare Pharmacy Claims Auditor will administer assigned Medicare Part-D ... and be very detail-oriented. Candidates will become an expert on the CVS Health Medicare Audit Programs and will own one or more of those program processes on… more
- Hartford HealthCare (Hartford, CT)
- …become part of Connecticut's most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of Compliance and ... coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal, state and private… more
- MedKoder (Mandeville, LA)
- …work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty ... and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer guidelines to ensure receipt of… more
- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description We are seeking a highly skilled Nurse Auditor who can understand the intricacies of standard medical coding, including ... of claim types and identifying claims requiring further review. The Nurse Auditor will also maintain productivity goals, uphold quality standards, complete special… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor I Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: Sept. 5, 2025 Apply with Linkedin Apply Department of Health ... to its staff. ABOUT THE POSITION: As a Staff Auditor I you will: + Perform professional audit work...grow personally and professionally as you acquire knowledge of Medicare , Medicaid, and Federal grants. REQUIREMENTS: To qualify, you… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... + Knowledge of medical coding systems + Knowledge of Medicaid/ Medicare Guidelines + Knowledge of billing rules and regulations....to thirty (30) pounds. ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** **… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Customer Service Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of...Serves as primary contact and liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of… more
- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description This role requires a thorough understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse ... Auditor is responsible for adjudicating claims to comply with...and auditing with extensive knowledge of medical coding and/or Medicare Guidelines. + Strong problem-solving skills and ability to… more
- AdventHealth (Tampa, FL)
- …cancer and other diseases. **The role you'll contribute:** The Coding Quality Auditor , under the general supervision of the Outpatient Coding Manager, is responsible ... for the internal coding audit and clinical quality reviews. The Coding Quality Auditor will work in conjunction with the Outpatient Operations Manager to ensure the… more
- UCLA Health (Los Angeles, CA)
- …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, and denied)...CPT-4, ICD-9CM, RBRVS, ASA, and HCPCS + Understanding of Medicare Guidelines and COB + Knowledge of medical terminology… more