Program Integrity Auditor - Medical Claims & FWA Specialist
NACBA
NACBA is seeking a Program Integrity Auditor to oversee the review of medical records for compliance with coding and documentation standards. This full-time role involves auditing operations across various healthcare segments, including Medicaid. Qualified candidates should possess 3–5 years of experience in claims data review and hold essential coding certifications like CPC, CCS, or CPMA. Benefits include medical coverage, paid time off, and retirement savings options. #J-18808-Ljbffr NACBA
$46.99k - $122.4k
...Position Summary The Program Integrity Auditor reviews records for medical, behavioral, transportation... ...of funds, rebilling of claims), and referral to state... ...fraud, waste, or abuse (FWA). The auditor ensures state... ..., CCS (Certified Coding Specialist), or CPMA (Certified...MedicalHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$90k - $100k
...Participate in a structured, full-time development program to transition into accredited thirdparty... ...steps toward independent thirdparty auditor status Your Qualifications Bachelor's... ...Occupational health and safety management Medical device quality systems Manufacturing or...MedicalPermanent employmentFull timeContract workFreelanceLocal area- Serco is seeking a Compliance/Fraud Specialist in Nashville, TN to support federal programs that assist millions with government health insurance. This role involves... ...years of relevant experience. Key benefits include medical and dental insurance, 401(k) matching, and robust...Suggested
- ...ensure that safety is seamlessly integrated into every aspect of the... ...Officer, the Safety & Security Auditor will conduct comprehensive... ...drills, and validation of safety program effectiveness across guest... ...procedures, including fire alarms, medical incidents, evacuations, and...MedicalLocal areaWorldwideShift work
- ...of only one year, along with medical benefits that start on day onewith... ...our performance management program, you can earn additional... ...the Sarbanes-Oxley Act (SOX). Auditors conduct thorough reviews of financial... ...the organization's financial integrity and operational efficiency...Medical
- Director, Coding Auditor & Educator (7410-2297) LifePoint... ...and auditing hospital medical records for coding... ...VP, Clinical Revenue Integrity General Responsibilities... ...reviews. Reviews claim denials and rejections... ...presents educational programs related to coding. Stays...MedicalWork at officeImmediate start
$71.3k - $124.5k
...seeking a Clinical Content Specialist - Nursing to join our dynamic... ...adoption of best practices, integrating our solutions into curricula... ...of competitive benefits and programs to help meet your needs and... ...but not limited to: Medical, Dental, & Vision Plans, 401...MedicalWork at officeRemote work$23.87 per hour
...Coding Auditor - Professional Coder Auditor-Professionals are responsible for auditing... ...modifiers, and charge posting. Interacts with medical staff, nursing, ancillary departments,... ...for coding quality audits for E/M Audit Program. Analyze and confirm assigned encounters...MedicalFull timeRemote work$71.1k - $97.8k
...Become a part of our caring community The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate... ...Parental and caregiver leave ~ Employee charity matching program ~ Network Resource Groups (NRGs) ~ Career development...MedicalBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayFlexible hours$30 per hour
...Auditor PMOUNTJP00001171 ~ Hourly pay: $30/hr ~ Worksite: Leading digital streaming network (Nashville, TN, 37201 - Onsite) ~ W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program, PSL ~40 hours/week, 9 Month Assignment A leading...MedicalHourly payShift work$95k - $105k
Senior Claims Specialist - TN Workers' Compensation page is loaded## Senior Claims Specialist -... ...large companies, using our deductible program. Our service in claims and loss control... ...attorneys and other vendors including medical case management, surveillance, etc.Physical...MedicalFull timePart timeSeasonal workWork at officeNight shift$100k - $125k
...in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL... .... Supports the organization\'s quality program(s). Qualifications Education & Licensing... ...offered including but not limited to, medical, dental, vision, 401k and matching, PTO...MedicalWork at officeLocal areaRemote workFlexible hours$132.8k - $219.1k
...you do it. Job Category Claim Compensation Overview... ...comprehensive compensation and benefits program, employees are also eligible... ...agencies, witnesses, agents, medical providers and technical... ...Support: Some Complex Claim Specialists may be responsible for all or...MedicalLocal area$17 - $20 per hour
Overview Medical Billing Auditor-Aleca Home Health As our company expands, we are actively seeking... ...development with our tuition reimbursement program, empowering you to advance your skills... ...bills or any fraudulent activity and claims are submitted in a timely manner....MedicalRemote jobWork at officeWork from homeFlexible hours$100k
...meet the unique coverage and claims-handling needs of businesses.... ...Construction Defect Technical Claims Specialist Employment Type: Full-Time... ...), denial of family and medical care leave, disability (mental... ...and a comprehensive benefits program-including health, dental,...MedicalFull timeLocal areaRemote work$100k
...meet the unique coverage and claims-handling needs of businesses.... ...Construction Defect Technical Claims Specialist Employment Type: Full-... ...), denial of family and medical care leave, disability (mental... ...and a comprehensive benefits program-including health, dental,...MedicalFull timeLocal areaRemote work- ...TANF Opportunity Pilot Program Auditor The TANF Opportunity Act (TOA) establishes the Tennessee Opportunity Pilot Program, which will provide $80 million across seven Pilot Programs, two in each of three grand regions within the state and one offered by the Tennessee...Contract workFor contractorsWork at officeLocal area
- ...entertainment company, is looking for an Auditor to join their team! This will... ...standards of professional integrity, act as a role model for the... ...a comprehensive benefit program for hourly employees. We pride ourselves on offering medical, dental, 401(k), direct deposit...MedicalHourly payContract workFreelanceWork at office
- ...EDI Claims Filing Specialist Location: Brentwood, TN 37027 Shift: 8 hours-flexible between 6 am... ...year of experience in healthcare-related medical claims billing (both paper and... ...Dental, 401K, and EAP (Employee Assistance Program) services. Nesco Resource provides...MedicalWork at officeLocal areaMonday to FridayFlexible hoursShift work
- ...Senior Internal Auditor Location: This role requires associates to be in-office 1-2 days per week... ...paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability...MedicalTemporary workWork at officeLocal area2 days per week1 day per week
$98k - $181k
...Senior Auditor – Internal Audit Location: U.S. (Remote) About the Role Scope,... ...actions. Support development paths and programs for audit team members. Multicultural... ...your 401(k)). ~ Multi-tier benefits (Medical, Dental, Vision) that you can tailor for...MedicalTemporary workRemote workWork from home- ...management. Reviews assigned portions of audit programs, determines compliance with policies... ...for management. Assists other auditors in completing their assignments as a means... ...nation’s largest providers of high-volume medical claims and transaction processing. We provide...MedicalFull timeFor contractorsWork experience placementWork at officeLocal area
- ...Direct Jobs is seeking a Professional Documentation Improvement Auditor to enhance the quality of clinical documentation. This role involves reviewing medical records to ensure accuracy and compliance and utilizing audit tools to analyze trends and provide feedback. The...Medical
- ...Ardent Corporate in Brentwood, Tennessee, is seeking a Professional Documentation Improvement Auditor. The role involves reviewing medical records and workflow processes to ensure accuracy and compliance. A strong candidate will have 3+ years of auditing experience, relevant...Medical
- ...Brentwood, Tennessee, is looking for a Professional Documentation Improvement Auditor to enhance the quality of clinical documentation. This position involves reviewing medical records and claims to ensure compliance with regulations while providing feedback and education...Medical
- ...Chief Risk Officer (CRO), the Internal Auditor I is responsible for participating in operational... ...in accordance with approved audit programs and guidance to determine the adequacy... ...compensation and full benefits including medical, dental, vision, health savings accounts...MedicalTemporary workWork at office
- ...Description Job Description **Senior Internal Auditor** Looking to make a direct impact on financial integrity? We're seeking a detail-oriented Senior Internal... ...competitive compensation package, including medical, dental, vision, short term/long-term disability...MedicalTemporary work
$68k - $80k
...Workplaces in Financial Services & Insurance Claims Adjuster - Workers Comp This role... ...is correct. May process complex lifetime medical and/or defined period medical claims which... ...Flexible work schedule. Referral incentive program. Opportunity to work in an agile...MedicalContract workFlexible hours$80k - $120k
...Operations Auditor DPR Construction is seeking an Operations Auditor with at least 5+ years in construction accounting experience.... ...important than your health and wellness. DPR offers a variety of medical, dental, vision and wellness benefits to keep you healthy....MedicalFor contractorsWork at officeFlexible hours$50k - $55k
...Workplaces in Financial Services & Insurance Claims Representative, Auto | Property Damage... .... Supports the organization's quality program(s). Travels as required.... ...is offered including but not limited to, medical, dental, vision, 401k and matching, PTO,...MedicalContract workWork at officeFlexible hours
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