- Prime Therapeutics (Madison, WI)
- …of that. It fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy ... to drive timely and accurate documentation receipt and review + Analyze pharmacy claims to identify those at the highest risk for error; utilize analytics… more
- Conduent (Chicago, IL)
- …and be part of a culture where individuality is noticed and valued every day. ** Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would ... in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy … more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Specialty Plans Auditor III is responsible for planning audits and audit...Preferred Provider Groups (PPG), Specialty Health Plans (SHP) and Pharmacy Benefit Manager (PBM) including LA Care's Claims… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …services, home health care services, durable medical equipment, rehabilitative therapies, and pharmacy reviews from finance and/or claims department . Prepare ... Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical… more
- New York State Civil Service (New York, NY)
- …HELP No Agency Attorney General, Office of the Title Forensic Auditor : Investigate Complex Healthcare Fraud (6383) Occupational Category Financial, Accounting, ... Criminal Justice DivisionMedicaid Fraud Control Unit - New York CityForensic Accountant/ Auditor Reference No. MFCU_NYC_FAA_6383Salary is $66,964 + $3,400 in location… more
- Health Advocates Network (Coral Springs, FL)
- …! This is a full-time contract position at a nationally recognized independent pharmacy / DME company located in **Coral Springs, FL.** + **Pay Rate: $20.00 per ... group of clinicians to ensure the documentation is clinically sufficient before claims are submitted to insurance companies for payment. Prioritize workloads to… more
- CVS Health (Tallahassee, FL)
- …day. **Position Summary** This candidate must reside in Illinois or Florida. As a Regional Pharmacy Onsite Auditor , you will be an essential part to the ... manner - Knowledge of CVS Health (or other PBM) claims processing - Knowledge of retail pharmacy ...PBM) claims processing - Knowledge of retail pharmacy operations including reading prescriptions and drug knowledge -… more
- Molina Healthcare (San Diego, CA)
- …+ Develop custom health plan reports related to managed care data like Medical Claims , Pharmacy , Lab and HEDIS rates + Assists and collaborates with the ... License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested in applying… more
Related Job Searches:
Auditor,
Claims,
Claims Auditor,
Pharmacy,
Pharmacy Auditor,
Pharmacy Claims Auditor Cpht