- WTW (Houston, TX)
- **Description** As a Medical Claim Lead Auditor , you will apply your audit, project management and client management skills to lead client audits. ... Develop working relationship with vendor counterparts + Distribute individual claim /work queues to team in a timely manner +...Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical ,… more
- Elevance Health (Boston, MA)
- …all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + ** Claims Auditor Senior** - all the above, plus : Service as a ... ** Claims Auditor I, II and Senior**... payment accuracy by verifying various aspects of the claim including eligibility, pre-authorization, and medical necessity.… more
- Elevance Health (Chicago, IL)
- …spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside...environment preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Elevance Health (Chicago, IL)
- …spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other… more
- Elevance Health (Chicago, IL)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- Northwell Health (Lake Success, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in ... Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area's fastest-growing physician practice… more
- Elevance Health (Atlanta, GA)
- …and medical policy guidelines strongly preferred + BA/BS preferred + Medical claims review with prior health care fraud audit/investigation experience ... **Nurse Auditor Senior - Payment Integrity Complex and Clinical...impact:** + Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- Accountant Auditor II - Confidential Print (https://www.governmentjobs.com/careers/mendocinoca/jobs/newprint/5179108) Apply Accountant Auditor II - ... office cash to internal and bank records. + Prepares claims for reimbursement of mandated costs. + Assists departments...functions. + May train other staff. + Serves as lead professional on special projects. + Perform other related… more