Senior Provider Auditor: Claims & Coding (Remote)
Scripps Health
- Remote job
Scripps Health in San Diego seeks a Senior Provider Auditor to analyze and audit managed care functions, including credentialing, claims, coding, and data integrity. The role involves educating staff, preparing materials for committees, and identifying root causes of regulatory deficiencies. Responsibilities include updating coding edits, validating new rules with IS/Tapestry teams, and coordinating Medicare Fee Schedule updates. Strong communication and healthcare experience are essential. #J-18808-Ljbffr Scripps Health
- ...time, benefit eligible position that is remote and located in San Diego. Will be... ...gastroenterology. Under general supervision, the Senior Provider Auditor utilizes key data to perform analysis... ...functions such as credentialing, claims, coding, provider information, timely access,...Remote workSeniorClaimsFull timeWork at office
$28k
...Senior Premium Auditor (Workers' Compensation) | 100% Remote Opportunity General Summary... ...Analyze and review claims to verify employment, proper classification coding and proper allocation of... ...a suitable space that provides a private and quiet workplace...Remote workSeniorClaimsWork from home$54.1k - $77.3k
...individual for an Inpatient Coding Auditor, Senior Associate who is responsible... ...which review services are being provided. This involves accessing... ...perform reviews of multiple claim types to provide a flexible... ...expect in this role ~ Remote within the U.S. ~ Benefits...Remote workSeniorClaimsFull timeContract workFlexible hours- ...Title Healthcare Compliance Auditor Job Description This... ...include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration... ...and billing for medical claims. Knowledge of medical...Remote jobSeniorClaimsWork experience placementWork at office
- ...a Patient Safety DRG Clinical Validation Auditor to audit inpatient medical records and ensure... .... The role requires extensive ICD-10 coding expertise and experience in DRG-related auditing. The candidate will analyze claims, generate detailed audit findings, and suggest...Remote jobSeniorClaims
$83.25k - $111.97k
JOB DESCRIPTION Job Summary Provides senior level support for health plan provider relations activities... ...pharmacy, quality of care, and correct coding). • Independently delivers training... ...customer service, provider services, or claims experience in a managed care or medical...Remote workSeniorClaimsFull timeContract workWork at officeNight shift$70.31k - $80k
...Description Description Job Title: Senior Claims Auditor Department: Ops - Claims... ...audits Review samples provider by clerical staff and... ...systems, comprehensive coding edits, Medicare guidelines,... ...Conditions This position is remotely based in the U.S. The home...Remote workSeniorClaimsHome office$30.46 - $45.69 per hour
...factors. Billing Compliance, Senior Auditor Reporting to the Manager of Billing... ...investigations related to coding, billing, documentation, and... ...and resolve risks affecting claim payment, in partnership with... ...Location: Hybrid (Evanston, IL and remote) Full Time/Part Time: Full-...Remote workSeniorClaimsHourly payFull timeContract workPart timeFor contractorsMonday to Friday- ...experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and... ...audit coding quality, resolve provider disputes, and collaborate across... ...while supporting cost reduction. Remote work with occasional travel to...Remote workClaims
- ...The role requires an RN or LVN and an inpatient coding certification within 4-6 months of hire. Responsibilities... ...reviews while documenting findings and managing claims. An excellent compensation package and benefits are provided, underscoring our commitment to employee well-...Remote workClaims
- ...Senior Auditor We are seeking an experienced Senior Auditor to support... ...ALS) program. This is a fully remote position supporting DOJ's... ...These contracts are designed to provide DOJ offices, boards, divisions... ..., Medicare billing and claims systems, or DoD inventory systems...Remote workSeniorClaimsFull timeContract workInterim roleWork from homeHome office
$30.5k - $42.5k
A leading healthcare solutions provider is looking for a Medical Claims Auditor to work remotely from Texas. The ideal candidate will review and analyze medical claims for accuracy and compliance, validate coding, and identify errors. With at least three years of relevant...Remote workClaims$71.32k - $112.84k
...Description : GENERAL OVERVIEW: Senior most coding auditor who evaluates medical records to... ...related to DRG, OPPS and outpatient claims. Reports findings both verbally and in... ...process changes and risk reduction. Provides guidance to System entities in response...SeniorClaimsFull timeFor contractorsLocal area$71.32k - $112.84k
...Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or... ...most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN... .... Advises UR/CM in defending payor claims denials for medical necessity, coding...SeniorClaimsFull timeFor contractorsWork at officeLocal area- ...seeking an experienced Inpatient Medical Coding Auditor to extract clinical information and... ...medical codes for inpatient hospital claims. This remote role involves reviewing claims for reimbursement accuracy and handling provider disputes. The ideal candidate will have...Remote workClaims
$71.1k - $97.8k
...experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly... ...HIPAA information.Travel: While this is a remote position, occasional travel to Humana's...Remote workClaimsFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayShift work- TruHealth is seeking a Coding and Medical Records Auditor to perform pre-claim and post-claim coding audits, verify ICD-10/HCPCS/CPT4 coding accuracy, and support... ...rules in managed care. You will work with provider relations and internal teams to ensure compliant, high...SeniorClaims
- ...rapidly growing managed service provider delivering innovative... ...seeking an experienced Medical Coding Auditor to support our continued growth... ...Understanding of billing platforms and claim workflows-how coding feeds... ...and occasionally exerting up to 10 pounds of force. #LI-RemoteRemote workClaims
- ...looking for a detail-oriented Claims Auditor to join our team in Sherman... ...Collaborate with claims processing and provider relations teams to resolve... ...ICD-10, CPT, and HCPCS coding standards Requirements:... ...impact in the healthcare industry. This is a remote position....Remote workClaimsWork at office
$76.3k - $131.55k
...at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle... ...the possible in healthcare. The Senior Coding Compliance Auditor will assist with the development and... ...and client experiences ~ This is a remote position; however, candidates must be...Remote workSeniorFull timeTemporary workWork at officeLocal areaImmediate startLong distance$50k - $55k
...Medical Claims Auditor (Remote - Texas) Join the group that solves business challenges and enhances the way we work and... ...regulatory standards. This role involves auditing provider-submitted claims, validating coding accuracy, and identifying errors or discrepancies...Remote workClaimsMonday to Friday- 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...Remote jobClaims
- A healthcare provider is seeking a Remote Medical Coding Auditor to conduct audits of medical claims and records. The role requires CPC certification and a minimum of 5 years of coding experience. Responsibilities include preparing reports on compliance issues, assisting...Remote jobClaims
- Walt Disney is seeking an experienced Auditor to review medical records, coding, and billing practices, ensuring compliance... .... Responsibilities include audits of claims, reporting findings, and providing education to staff. Remote/hybrid work options may be available;...Remote jobClaimsWork at office
- CorVel Corporation is seeking a Provider Management Analyst to verify provider information and audit documentation for claims, including itemized bills, medical records, UB04s, and HCFAs. This remote role emphasizes accuracy and timely processing. You will collaborate with...Remote jobClaims
- ...Our Caring CommunityThe Senior Medical Coding Outpatient Auditor is responsible for coding... ...ResponsibilitiesResearch claims anomalies to identify outpatient... ...effectively, the self-provided internet service of Home... ....Travel: While this is a remote position, occasional...Remote workClaimsTemporary workApprenticeshipWork at officeWork from homeHome office
- CorVel Corporation, CERIS division, seeks a Provider Management Analyst to verify provider information and documentation for claim audits, including itemized bills and medical records. This is a remote position. Responsibilities include communicating with leadership, maintaining...Remote jobClaims
- ...people live healthier lives. This full-time position involves provider education via phone and email on coding and documentation guidelines, and auditing outpatient claims for accuracy. The role is remote from anywhere in the United States, with CST hours 8:00 AM-4:00...Remote jobClaimsFull time
- ...seeking a talented individual for a remote Outpatient Coding Auditor (Professional and Facility), the consultant... ...for which review services are being provided. This involves accessing systems to... ..., and modifier codes. • Review claims to validate submitted codes and...Remote workClaimsContract workWork at officeShift work
- ...Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment Centers is an equal opportunity... ...family of professionals dedicated to providing the most accessible, highest quality,... ...Coding Auditor Conducting audits of claims and patient records to identify incorrect...Remote workClaimsTemporary workMonday to FridayShift work
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