- Prime Therapeutics (Lansing, MI)
- …career? Come build the future of pharmacy with us. Job Posting Title Pharmacy Claims Auditor - Remote Job Description The Pharmacy Claims ... in-depth analysis of large datasets and audit findings to detect high-risk pharmacy claims , identify billing irregularities, and uncover patters of… more
- UnitedHealth Group (Minneapolis, MN)
- …our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you ... . In this position as a Coding & Clinical Auditor / DRG Specialist RN , you will apply...AHA Coding Clinic Guidelines in the auditing of inpatient claims . Employing both industry and Optum proprietary tools, you… more
- Healthfirst (NY)
- …performance to ensure the quality of the network.** + **Review and investigate claims and encounters for medical, facility, pharmacy , dental and vision services ... **This position is 100% Remote .** **Scope of Responsibilities:** + **Conduct moderately complex...**Conduct moderately complex to complex quality audits of provider claims , pre-payments and post-payments including high-dollar and specialized … more
