Medical claims auditor jobs in United States

The Clinical Documentation Integrity (CDI) Auditor is responsible for providing expert second level review to ensure the quality and integrity of medical records. Responsibility includes validating ICD-10-CM/PCS codes by examining medical record documentation of clinical findings, care rendered, ...

ChristianaCare is searching for a Corporate Compliance & Privacy Auditor to join the team.This position will execute moderate-to-complex level audits and participate in the evaluation of the adequacy, effectiveness, and efficiency of internal controls and identify weaknesses, along with providing...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sens...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sens...

*Must be permanently authorized to work in the U.S. as a precondition of employment. Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of...

Description: THE POSITION. This position is responsible for reviewing and processing claims, including facility claims, to ensure accuracy prior to payment release. This position is the lead responder to Health Plans and IMS Clients for all products and lines of business. Responsible for manageme...

Holidays, Medical, Dental, Vision, and more. * Requirement: Claims Processing experience, Facility ... Minimum of 5+ years as a "Medical Claims Auditor," in a health plan, managed service/care ...

... Auditor Trainer to join our team in Stockton, California. Job Summary: Audits Claims, Customer ... The health insurance components include medical, dental and vision. Additional health benefits ...

The Claims Auditor will identify overpayments and coordinate with the Claims Recovery Unit ... medical terminology 6. Must have an understanding to read and interpret DOFRs and Contracts. 7. ...

Provide insureds and internal customers (underwriting, claims, and accounting) with information to ... Extremely competitive Medical, Dental, Vision and Life plans * Employer matching 401(k) plan

Analyze and interpret operative reports from physicians, as well as billed charges and claims from ... Medical knowledge a plus. * Strong organizational skills and excellent interpersonal skills

... potential claims and the preparation of a report of findings. Excellent verbal and written ... Medical, Dental and Vision coverage * Flexible Spending Account * Basic Life and AD&D * Voluntary ...

Conducts monthly monitoring reviews of medical records to determine coding accuracy of all ... Reviews claims to validate submitted codes and abstracted data including but not limited to ICD-10 ...

... auditing, and cross-training on package protocols per assignment). * Maintain confidentiality of ... Two (2) years of audit or recovery experience, preferably with medical claims. * Ability to ...

Associate's Degree * Claims auditing experience. Licensure, Certification, Registration Required * None Preferred * Certified in medical coding or auditing What You Will Get: HPSJ Perks

... auditing services, back office or run-out administration, quota share and excess medical ... The Claims Manager supports medical insurance customers (including administrators, MGUS, brokers ...

Understanding of auditing and reporting tools such as SQL * Presentation skills and client ... Benefits Boost Healthcare provides a competitive benefits package including medical, dental, vision ...

... also auditing data input for all components of revenue cycle management. You will: * Analyze ... Analyze hospital billing claims within the EHR and claim scrubber system. * Resolve claim errors ...

... claims cost and reserve information as required per the annual report and to financial auditors as ... ill employee, the medical provider community, the TPA (third party administrator), facility ...

... medical claims; analyzing and optimizing bill review procedures and systems; and leading a team of experienced medical bill review auditors, nurse auditors, med-legal nurse, negotiators and related ...

... claims, LOAs, ensuring compliance with employment laws and regulations. * Provide support to ... Employee compensation administration, timecard auditing/processing, and payroll management

Responsible for working with all departments to ensure edits are cleared and clean claims billed to ... Experienced Medical Auditor * RN/LPN License Skills / Knowledge / Abilities Communication is an ...

... auditing. Essential Duties and Responsibilities : * Determine medical necessity requirements for ... Submit claims to insurance companies, Medicaid, and Medicare following established guidelines

... claims cost and reserve information as required per the annual report and to financial auditors as ... ill employee, the medical provider community, the TPA (third party administrator), facility ...