- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Claims Quality Review Auditor is HYBRID position accountable for auditing various claims to ensure quality and accuracy to ... and procedures and regulatory guidelines. Makes recommendations to improve quality , workflow processes, policies and procedures. **ESSENTIAL FUNCTIONS OF THE… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Quality Auditor II Job Category:...researches on complex claims problems. Duties Performs high quality review of payable and post payment ... net required to achieve that purpose. Job Summary The Claims Quality Auditor II works...changing work environment. Perform random review of claims audited by the Quality Control Examiners… more
- JBS USA (Greeley, CO)
- **Description** Claims Auditor Purpose and Scope/General Summary: We are looking for a Claims Auditor for our Fed Beef division. This role will sit at ... our Corporate office in Greeley, CO. The Claims Auditor responds to notifications of discrepancies...These notifications may be in regard to product integrity, quality , damage and/or count discrepancies. It is the role… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, September 9, 2024 Centers Plan for Healthy Living's goal is to create the ... their use and identifying any deficiencies. + Prepare summaries for management of quality review results, including basic analysis of identified trends. +… more
- Rising Medical Solutions (Chicago, IL)
- …born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment. Join ... + Consistently meet productivity and turn-around time requirements. + Adhere to quality standards, state billing guidelines, HIPAA rules, and confidentiality of all… more
- Humana (Salt Lake City, UT)
- …is looking for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- State of Colorado (Denver, CO)
- Risk Mitigation Auditor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4656593) Apply Risk Mitigation Auditor Salary $70,140.00 - ... CO Job Type Full Time Job Number KAA 9570 Auditor III 9.24 MR Department Department of Labor and...who exhibit our shared values and our passion for quality and excellence in all we do. In addition… more
- Fallon Health (Worcester, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Elevance Health (Indianapolis, IN)
- …lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by ... **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid...processes and processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …ensuring coding accuracy, coding consistency and efficiency in filing of inpatient claims . Collaborates with the Clinical Documentation Quality Liaison to assist ... as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for… more