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Senior Clinical Provider Auditor - Payment Integrity

Elevance Health

Elevance Health, a leading health services company, seeks a Clinical Provider Auditor II to evaluate fraud and abuse risks in claims and medical records, ensuring compliance with billing guidelines. This role supports hybrid in-office and remote collaboration within a dynamic healthcare environment. The position requires 5+ years in medical coding/auditing with fraud, waste, and abuse experience and coding certifications (CPC/CCS/CPMA). #J-18808-Ljbffr Elevance Health

Vacancy posted 1 day ago
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