SUMMARY The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures... appropriate payment of claims and maintenance of the claims system as necessary. SPECIFIC SKILLS NEEDED Knowledge of HMO/or IPA...
innovation. Req ID : 13340 Working Title : Outpatient Surgical and Claims Edit Auditor Department : CSRC Coding Audit.... What will I be doing in this role? The Coding Auditor works under the general direction of the Coding Supervisor. A Coding Auditor...
The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim... Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim...
Job Description The Senior Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files... in-depth claims file reviews for accuracy and compliance. Document findings and provide recommendations for corrective action...
Claims Auditor AIPSO is a management organization and service provider for various insurance industry groups.... www.aipso.com Position: Temporary/Contract Role – Claims Auditor *Individual will be paid through Volt - a third-party...
every day. Job Overview The Claims Auditor will be responsible for the accurate review and auditing of claims... that are adjudicated by the system and the Claims Examiners. The auditor will suggest process improvements to management and act...
. Summary The Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance..., and adherence to company and regulatory standards. This role involves auditing provider-submitted claims, validating coding accuracy...
. Summary The Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance..., and adherence to company and regulatory standards. This role involves auditing provider-submitted claims, validating coding accuracy...
The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers... CQA auditor will coordinate Health Plan’s audits activities with preparation and provide preliminary results on non...
The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers... CQA auditor will coordinate Health Plan’s audits activities with preparation and provide preliminary results on non...
every day. Job Overview The Claims Auditor will be responsible for the accurate review and auditing of claims... that are adjudicated by the system and the Claims Examiners. The auditor will suggest process improvements to management and act...
claims and related documentation; request missing information as needed. Verify eligibility, plan benefits, and stop-loss... and compliance purposes. Review, analyze, and adjudicate high-dollar and complex medical stop-loss claims; Identify cost-containment...
for all Partnership lines of business. Responsibilities: Perform concurrent and retro claims audits on new Claims examining staff... and on claims processed by existing Claims staff as outlined in Claims Operating Instruction Memorandums for all lines of business...
for all Partnership lines of business. Responsibilities: Perform concurrent and retro claims audits on new Claims examining staff... and on claims processed by existing Claims staff as outlined in Claims Operating Instruction Memorandums for all lines of business...
guidelines Follow up on claims needing additional information Refer problem claims to a Lead and/or auditor for additional...This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money...
and freedom. Could This Be For You? The Priority Claims Specialist III - Remote will ensure payment for services provided... and understanding of DMEOPS CPT and ICD-10 codes. Utilize the company billing and collections system to identify and resolve any claims...
Overview: To research and resolve complex claims issues which cross interdepartmental lines and communicate the... regarding claims related questions. Reviews, researches, and works with various departments to resolve complex provider...
and freedom. Could This Be For You? We are seeking a Priority Claims Specialist III - Remote. Primary responsibilities... includes reviewing complex claims, patient records and hospital and physician billing practices and identifying...
and freedom. Could This Be For You? The Priority Claims Specialist III - Remote will ensure payment for services provided... and understanding of DMEOPS CPT and ICD-10 codes. Utilize the company billing and collections system to identify and resolve any claims...
Medical Coding Auditor (Per Diem) What you will be doing: The Medical Coding Medical Coding Auditor conducts.... The Medical Coding Auditor staff will also contribute to the ongoing development and refinement of proprietary audit tools...