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Senior Claims Audit Specialist (Managed Care)

Providence Health Plan Group

Providence Health Plan Group is seeking a dedicated audit professional to maintain delegated auditing functions for managed care claims. You will review pre- and post-payment activities, document errors, and report processing issues to ensure CMS, DMHC, and DHCS compliance. Reporting to the Supervisor, Claims Audit, you will safeguard data integrity and support a culture of patient-focused, whole-person care across Providence. #J-18808-Ljbffr Providence Health Plan Group

Vacancy posted 2 days ago
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