- Elevance Health (Indianapolis, IN)
- ** Clinical Provider Auditor I - Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law._ **Carelon Payment Integrity** is a proud member of the Elevance...to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor I** will… more
- Elevance Health (MD)
- ** Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Location: Must be located in Maryland.** This field-based role ... an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance...to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II** is… more
- Elevance Health (Norfolk, VA)
- ** Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II** is...conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …communities that we serve through our Healthsource blog: https://healthsource.premera.com/ . As a ** Payment Integrity Auditor I** , you will support the overall ... objectives of the Payment Integrity office. This role is responsible for conducting...and policy non-compliance. Audits include reviewing medical records, applying clinical and coding knowledge, analyzing provider billing… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days-Option to work remote or hybrid.** The Clinical ... to patients are accurately documented, coded, and submitted for payment . This position plays a key role in ensuring...compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position… more
- Elevance Health (Denver, CO)
- …of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Humana (Boise, ID)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... a bi-weekly payment for their internet expense. * Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Plans' provider agreements and the National Healthcare guidelines. The Professional Auditor helps improve clinical outcomes and quality of care, to reduce ... true colors to blue. About the Role: The Professional Auditor is responsible for post-pay review to verify the...post-pay review to verify the accuracy of claims reimbursement, clinical significance, coding, and billing in accordance with the… more
- Catalent Pharma Solutions (Winchester, KY)
- …Important Security Notice to US Job Seekers: Catalent NEVER asks candidates to provide any type of payment , bank details, photocopies of identification, social ... **AR&D Associate Data Auditor ** Catalent, Inc. is a leading global contract...executing a broad range of high visibility tasks to provide scheduling and alignment for the AR&D Department in… more
- HCA Healthcare (Caldwell, ID)
- …recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon. **This is a fully work from home position.** **This ... by location._** We are seeking an Inpatient Coding Quality Auditor for our team to ensure that we continue...for our team to ensure that we continue to provide all patients with high quality, efficient care. Did… more