- Elevance Health (South Portland, ME)
- ** Clinical Provider Auditor II ** _Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Provider Auditor II is responsible for… more
- Elevance Health (Richmond, VA)
- ** Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** _Location:_ Alternate locations may be considered. This position ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II ** is responsible for… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor II Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: April 30, 2025 Apply with Linkedin Apply Department of ... to its staff. ABOUT THE POSITION: As a Staff Auditor II you will: + Perform independent...and standards. + Analyze budget and expenditure information and/or clinical and professional records in a forensic capacity requiring… more
- Omnicell (Grapevine, TX)
- **Job Description:** The Regulatory Auditor position plays a critical role in safeguarding the integrity and compliance of pharmacy operations. This position is ... to transforming pharmacy care through outcomes-centric innovation designed to optimize clinical and business outcomes across all settings of care. We strive… more
- The County of Los Angeles (Los Angeles, CA)
- …the level of the County of Los Angeles class of Senior Contract Program Auditor **. PHYSICAL CLASS: Physical Class II - Light: This class includes administrative ... HEAD CONTRACT PROGRAM AUDITOR / EMERGENCY APPOINTMENT HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4448498) Apply HEAD… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- Summary The Medical Record Technician (Coder) Auditor is a staff position located under the Health Information Management Division of the Facilities Support ... Facilitate improved overall quality, completeness, and accuracy of coded data. Provide recommendations on appropriate coding and are responsible for maintaining… more
- Veterans Affairs, Veterans Health Administration (Fredericksburg, VA)
- …person to appropriate leadership and groups. Collaboratively works with coding staff and clinical staff to provide support and education on coding issues. ... settings, group practices, and multi-specialty clinics. The MRT (Coder) Auditor (Outpatient) facilitate improved overall quality, completeness, and accuracy of… more
- Highmark Health (Harrisburg, PA)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system...+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- LA Care Health Plan (Los Angeles, CA)
- HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's… more