Healthcare Program Integrity Auditor
NACBA
NACBA is seeking a Program Integrity Auditor to review Medicaid claims and ensure compliance with coding and documentation standards. Responsibilities include serving as an audit team member, identifying billing patterns, and providing education to providers. The ideal candidate will have 3-5 years of experience in claims data review and hold a CPC, CCS, or CPMA certification. This full-time role is essential for maintaining regulatory integrity across multiple lines of business within the health plan and offers significant benefits. #J-18808-Ljbffr NACBA
$46.99k - $122.4k
CVS Health is looking for a Program Integrity Auditor in the United States to manage audits of medical records for coding and documentation compliance. Candidates should have 3-5 years of experience in claims data review and hold an active CPC, CCS, or CPMA license. Duties...Suggested$46.99k - $122.4k
...person, one family and one community at a time. Position Summary The Program Integrity Auditor is responsible for the review of records for medical, behavioral, transportation, and other healthcare providers. The Auditor must have the ability to determine correct coding...SuggestedHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...SuggestedRemote work
$100k - $102.5k
...accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing... ...reviews, or payment integrity programs.Familiarity with data analytics...Suggested- ...intersection of Compliance, Payment Integrity, and Data Infrastructure. The... ...investigates instances of healthcare fraud, waste and abuse (FWA).... ...the Role As a Medical Claims Auditor within our Special... ...compliant, effective FWA audit program. You will be joining a fast‑growing...SuggestedWork at officeRemote workFlexible hours
$46.99k - $122.4k
Hispanic Alliance for Career Enhancement is seeking a Program Integrity Auditor to ensure compliance with coding standards and review healthcare records. This role requires 3-5 years of claims data interpretation experience and an active CPC, CCS, or CPMA license. Responsibilities...Full time- A leading healthcare provider in New York seeks a Clinical Revenue Auditor to ensure the accuracy of medical billing and compliance with regulations. Ideal candidates will have 3-5 years of clinical experience, knowledge of medical coding, and proficiency with medical...Remote jobFull time
$84k
...Sr. Internal Auditor – Ensemble Ensemble is a leading provider of technology... ...of redefining the possible in healthcare by conducting internal financial, operational, and integrated IT audits of revenue cycle and... ..., retirement, and well‑being programs. Culture of collaboration,...Temporary workWork at officeRemote work$90k - $115k
...Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency... ...and complete documentation, ultimately contributing to the integrity and efficiency of the payment process. What you’ll do Audit...Contract workWork experience placementRemote workFlexible hours- ...Clover Health, LLC is seeking a Medical Claims Auditor to enhance its healthcare fraud audit program. The selected candidate will collaborate with the Special Investigations Unit to review claims for billing issues and identify fraud opportunities. Candidates should have...Remote work
- ...and the planet. Join us and make a difference too! ISO 7101 Auditor – Healthcare & Veterinary Assurance Location: US – Remote Employment... ...You will lead audits against ISO 7101, while also bringing integrated management systems experience in ISO 9001, ISO 45001 and ISO...Full timeContract workTemporary workLive inRemote workFlexible hours
- ...A health insurance company is seeking a Senior Specialist, Coding Auditor to join their Payment Integrity team. This remote position involves supporting issue resolution, ensuring claims repayment quality, and assisting in root cause analysis. Candidates should have 1+...Remote work
- ...A healthcare recruitment agency is seeking a Clinical Coding Auditor & Trainer for a primarily remote role, requiring travel to New York twice a year. The successful... ...will be responsible for developing training programs and conducting quality auditing for the Diagnosis...Remote work
$115k - $130k
...responsible for managing their North America ANAB Accredited Aerospace program. The role involves conducting audits, supporting business... ...should possess a Bachelor's degree and be certified as a Lead Auditor for AS9100 and AS9120 standards. This position is 100% remote...Remote work- ...Integrated Management Strategies is hiring a fully remote Medical Coding Auditor to join their healthcare consulting practice. The role requires a current coding credential, DoD Medical Coding auditing experience, and at least one year of coding management experience....Contract workRemote work
- ...A healthcare organization is seeking a Clinical Coding Auditor & Trainer to develop training programs and conduct audits primarily remotely. Candidates must be attentive to quality and have significant experience in auditing within healthcare. The position requires a willingness...Full timeRemote work
$96.46k - $144.69k
...Description Description Clinical Revenue Auditor-CDM Patient Financial Services-Corporate... ...acumen to ensure compliance with healthcare regulations and collaborate with staff to... ...Knowledge of insurance and governmental programs, regulations, and billing processes (e.g...Full timeTraineeshipRemote work- A healthcare provider is seeking a Compliance Auditor to safeguard revenue and reputation through various audit activities and compliance education. The role... ...in government audits and development of educational programs for over 500 healthcare professionals. Candidates...
- COMPLIANCE AUDITOR page is loaded## COMPLIANCE AUDITORremote type: On-sitelocations: NY... ...implement comprehensive, risk‐based audit programs to assess compliance with governmental,... ...Experience:*** Minimum of three (3) years Healthcare Audit background preferably in a Health...Local area
$81.6k - $102k
...NY Department of Health (DOH)* Centers for Medicare and Medicaid Services (CMS)* National Government Services (NGS)* Medicaid Integrity Program Contractor (MIC)* Recovery Audit Contractor (RAC)* Zone Program Integrity Contractor (ZPIC)* Health Care Fraud Prevention and...For contractorsWork at officeLocal areaShift work$85k - $90k
...Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate... ...reduction, ultimately improving access to healthcare. We achieve this by aligning the common... ...parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review...Work at officeRemote work- ...A healthcare consulting firm is seeking a professional for a coding role focused on Medicare and Medicare Advantage initiatives. Responsibilities include validating diagnosis codes, auditing information, and performing high-volume chart reviews with specific productivity...Hourly pay
- ...Auditor Position The ideal Auditor will be located in New York, Pennsylvania, Ohio,... ...Initiative (SFI) Other Chain of Custody Program services, as applicable Essential... ...auditing circumstances while maintaining the integrity of the certification scheme (e.g. FSC,...Contract workWork experience placementWork from homeHome office
- ...A leading healthcare company is seeking a full-time remote Auditor to provide a range of audits, business advisory, and consultation services. This position requires a Bachelor's degree and 5 years of auditing experience. Responsibilities include conducting operational...Full timeRemote workFlexible hours
$90k - $115k
...Senior Social Compliance Auditor (CSCA Certified) Full-time Compensation: USD 90,000 -... ...as the global benchmark for quality and integrity. With more than 96,000 employees, SGS operates... ..., life insurance, employee wellness programs Wealth: Competitive pay, 401(k) with company...Full timeWork experience placementImmediate startWeekend work$90k - $115k
...A healthcare intelligence company is seeking a DRG Reviewer to conduct payment validation reviews. The ideal candidate will possess a nursing degree or equivalent, with at least two years of inpatient claims auditing experience. Responsibilities include auditing medical...Remote workFlexible hours- ...Auditor Start your career here at the NYC Campaign Finance Board. ABOUT THE CAMPAIGN... ...voters' doors. Our public matching funds program ensures small contributions can make a big... ...has a direct impact on maintaining the integrity of New York City's matching funds...Work at officeLocal area
- ...Datavant is seeking a Professional Auditing Specialist to perform coding audits and ensure compliance in healthcare. This fully remote position requires over 5 years of coding experience, strong organizational skills, and CPC certification. The role involves educating...Remote work
$89k - $106k
...North America Regional Compliance Principal Auditor The Compliance Team is committed to... ...maintain our highest standards of integrity, ethical behavior and trust, as they are... ...the implementation status of compliance programs as required. Preparing, performing and...Permanent employmentFull timeWork at officeLocal areaVisa sponsorshipWork visa$95.71k
...operates the country’s largest Section 8 program, which provides rental assistance to... ...Asset & Capital Management (A&CM) Division integrates and aligns the Authority’s existing development... ...Engineering Audit Officer, Engineering Auditors assist in performing these audits and...Permanent employmentFull timeContract workFor contractors
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