- University Hospital New Jersey (Newark, NJ)
- …Data Quality Auditor /Educator is to ensure the consistent processing of claims and collection of data to optimize DRG reimbursement and produce quality data ... or a related field required. RHIA or RHIT certified preferred . CCS required. If not CCS certified, must obtain...an encoder (Clintegrity 360) and Epic electronic health record preferred . Must have the ability to balance multiple and… more
- ChristianaCare (Wilmington, DE)
- ChristianaCare is searching for a Corporate Compliance & Privacy Auditor to join the team.This position will execute moderate-to-complex level audits and participate ... RHIT) Equivalent experience of 5+ years' experience in provider auditing, claims auditing, compliance auditing, quality assurance, and/or recovery auditing Coding… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …in conducting education to providers and large audiences required.Other: Preferred Job QualificationsPreferred Licensure or other certifications: Preferred ... discuss concerns, and make plans for processes/procedures.Assists with submission of charges/ claims during high volume and/or end of month. Assists, as needed,… more
- Blanchard Valley Hospital (Findlay, OH)
- …by clinical documentation. Coordinate with the Professional Coding Integrity Auditor /Educator to research coding questions from offices, departments, and providers. ... of associates in conjunction with the professional coding integrity auditor /educator when needed, coordinate staff schedules, payroll, completion of associate… more
- Blanchard Valley Hospital (Findlay, OH)
- …support optimal and accurate charge processes; collaborate with CDI Specialist, Claims Resolution Specialist, Revenue Integrity Auditor , Revenue Integrity ... appropriate resources, as needed, to resolve. Duty 2: Support resolution of claim -scrubber edits (Quadax) resulting from charges entered by the Revenue Integrity… more
- Amerant Bank (Miramar, FL)
- …Business Continuity in providing regulators, internal and external auditor 's information regarding the Organization's Operational Risk Management framework.Support ... contact for insurance related matters including but not limited to claims reporting, premium payments, and certificate of insurance requirements. NON-ESSENTIAL… more
- Oak Orchard Health (Brockport, NY)
- …+ Associates Degree in Business or related field, or public/private payor background preferred . + Licensed Healthcare Auditor (LHA or CPMA) or willing to ... Healthcare Compliance Auditor Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) * Compliance & Risk Description Do you want to be… more
- HCA Healthcare (Campbell, CA)
- …with purpose and integrity. We care like family! Jump-start your career as a(an) Claim Auditor today with HCA Healthcare. **Benefits** HCA Healthcare, offers a ... vary by location._** Come join our team as a(an) Claim Auditor . We care for our community!...required . Customer service skills required . Prior medical claim auditing experience preferred Physician Services Group… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... experience Preferred : Type of Experience Required: 2+ years of claim processing experience with a Medicaid/Medicare Health Plan. Preferred : Experience… more
- UPMC (Pittsburgh, PA)
- **UPMC Health Plan is looking for an Intermediate Clinical Auditor /Analyst to join the Quality Assurance team!** The Intermediate Clinical Auditor /Analyst is an ... to ensure correct DRG procedural and diagnosis codes have been used appropriately on claims . This role also acts as a SME for the department in representing… more
- Robert Half Accountemps (Los Angeles, CA)
- …and finalizing DNB edits either in the PFS host Patient Accounting system or claims editing system. At times, the Chart Auditor may conduct insurance audits ... in Los Angeles is in the need of Chart Auditor . The Chart Auditor is responsible for...issues. + Consistently and thoroughly work DNFB and PFS claim edits work lists to ensure timely completion within… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency SUNY System Administration Title Internal Auditor Occupational Category Financial, Accounting, Auditing Salary Grade NS Bargaining Unit M/C - ... skills, including ability to problem solve and apply situational knowledge. Preferred Qualifications:One to two years of related audit experience.Knowledge of… more
- Elevance Health (Plano, TX)
- **Clinical Medical Records Auditor ** A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and ... home setting. **Location:** Plano, Texas The **Clinical Medical Records Auditor ** is responsible for the audit and review of...review of medical record documentation for the support of claim payments. **How You Will Make an Impact** Primary… more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot ... Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL...with a major in accounting or a related field. Preferred Qualifications: In addition to meeting the minimum qualifications,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
- Tennessee Comptroller of the Treasury (Nashville, TN)
- Auditor : Financial/TennCare This role focuses on examining, analyzing, and reviewing records, financial statements, claims data, and cost reports for providers ... The Comptroller of the Treasury is recruiting for a full-time Auditor : Financial/TennCare position in the Division of State Audit's Tenncare/Medicaid Section.… more
- Elevance Health (Houston, TX)
- …in a production environment strongly preferred . + Proficient in MS Office preferred . + Prior experience processing claims strongly preferred . + ... **Performance Quality Auditor I** **Location:** This is a remote position....Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Zelis (St. Petersburg, FL)
- Position Overview The Member Services Trainer/ Auditor is a vital role in ensuring service excellence to Open Access Pricing clients and their members. The Trainer/ ... Auditor will be responsible for designing, developing, implementing, and...experience in technical training, adult learning, or talent management Preferred Qualifications + Experience building out learning processes and… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) ... the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. ** Preferred Qualifications** + Other : Strong background in in ICD-10-CM/PCS coding,… more
- NJM Insurance (Trenton, NJ)
- Our Commercial Lines department is seeking a Premium Auditor with strong organizational and time management skills. The auditor will be responsible for ... policyholder. + Collaborate with Underwriting, Loss Prevention, Workers' Compensation Claims , Special Investigations Unit to ensure policyholders and department… more
