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
- Pharmacy Auditor - Payment Integrity Complex and Clinical Audit Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach...SuggestedContract workTemporary workWork at officeLocal area2 days per week1 day per week
- Elevance Health is seeking a Pharmacy Auditor to join our Payment Integrity Complex and Clinical Audit team in a hybrid in‑office role. The candidate will review professional and facility claims, focusing on high‑cost drugs, home infusion therapy, renal claims, and DME...SuggestedWork at office
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) CGI is seeking a results-oriented Senior... ...to rules design, clinical validation, and deployment... ...false positives, ROI, and provider abrasion. Continuous Improvement... ...Directors and internal auditors (RNs/Coders) to ensure...SeniorLocal areaRemote work$127k - $160.55k
...Senior Solution Advisor The Senior Solution Advisor will serve... ...Matter Expert on the Payment Integrity portfolio. The Senior Solution... ...Price Optimization solutions by providing pre and post sales... ...Case Management required (ex., clinical and coding bill review/audits...SeniorFull timeWork at officeLocal areaVisa sponsorshipFlexible hours$86.56k - $155.81k
...Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and... ...person training sessions, providing maximum flexibility and autonomy... ..., supports work-life integration, and ensures essential face... ...claims billing and payment systems, provider billing...SuggestedFull timeWork at officeLocal area$67.9k - $199.14k
...one community at a time. Position Summary The Senior Manager - Business Consulting, within the Payment Integrity Center of Excellence (PICOE) team, will help formulate... ...G&A (reducing appeals, claim rework, and provider settlements), maximizing revenue, centralizing vendor...SeniorHourly payFull timeTemporary workWork experience placementLocal area- Deluxe Corporation is seeking a Chief Architect responsible for leading the Enterprise Architecture practice and establishing Integrated Payments Platforms. The Chief Architect will set the technical direction, collaborate with product and engineering leaders, and mentor...Senior
- ...Senior IT Auditor As a Senior IT Auditor, you will be responsible for evaluating and assessing... ...-functional teams, identify risks, and provide recommendations to improve IT processes... ...IT controls related to security, data integrity, confidentiality, and access management...Senior
- ...strategies and operating models integrating planning, sourcing,... ...industry trends, procurement-to-payment processes, and fulfillment programsDevelopment... ...or a related field:Direct clinical support environment with... ...by local law, Accenture provides a reasonable range of compensation...SeniorFull timeWork experience placementLive inWork at officeLocal area
- ...across teams to ensure financial reporting integrity. When Hiring immediately for a full-... ...experience. Position Overview The Senior SOX Auditor plays a critical role in ensuring... ...efforts. Document control deficiencies and provide actionable insights. Collaborate...SeniorFull timeWork at officeImmediate start
- ...intelligent platform with end-to-end payments capabilities and services... ...Title: Internal Audit Senior (Financial and Business Process... ...Description SummaryThe Senior Auditor is responsible for executing... ...policies, and IIA Standards.Provide guidance and mentoring to staff...SeniorFull timeWorldwideFlexible hours
- ...and entertainment-focused CPA firm that provides comprehensive client services beyond... ...expertise and advisory capabilities, which are integral to every engagement. The team... ...this niche sector. Role Description The Senior Auditor will perform and lead audit engagements...SeniorFull timeWork at office
$86.4k
...approvals have been obtained throughout the project lifecycle. Provide required business and/or subject matter expertise for both... ...Insurance or Healthcare Industry experience ~ EPM/Oracle, Data Integration or Power BI SKILLS Analytical Skills Communication...SeniorFor contractorsWork at officeLocal area- ...business process reviews); growth (M&A due diligence and business integration); and operational excellence. Assists in the evaluation of... ...reports detailing the results of the audit with a focus on providing insightful and value-added recommendations to all stakeholders...SeniorNight shift
- ...all sizes. Job Summary As a Senior Internal Audit Manager, Technology, you... ...technology are managed across the Group and provides a strong platform for progression into... ..., manufacturing) ~ Act with integrity and objectivity, exercising professional...SeniorWork at officeLocal areaWorldwide
$70.8k - $123.8k
...Clinical Nurse Auditor CGI is one of the world's largest independent IT and business consulting... ...and necessity of healthcare services provided to members of commercial and government... ...support the identification of improper payments while ensuring audit decisions are objective...Work at officeRemote work- ...you are a qualified Internal Auditor with experience in a multinational... ...this job is for you! The Senior Internal Auditor will be... ...risk management. Provide consultative support on assigned... ...organization. Working knowledge of integrated accounting systems. JDE, SAP,...SeniorFor contractorsWorldwide
$26.6 - $32.41 per hour
...your career and be what you want to be. We provide: Comprehensive health benefits that... ...Description JOB SUMMARY:The Data Integrity Specialist II maintains the accuracy, reliability... ...functions, for all Emory Healthcare clinical entities.JOB RESPONSIBILITIES:Manages and...SeniorHourly pay- ...We are seeking dynamic and driven Audit Senior Associates or Audit Supervisors with 1‑5... ...auditing, and related issues and developments Provide supervision, training, and support to... ...Continuing Education Culture based on integrity, respect, accountability, and excellence...SeniorWork at officeFlexible hours
- ...Emory Healthcare is seeking an experienced Inpatient DRG Coding Auditor in Atlanta, Georgia. The role involves reviewing inpatient... ...accuracy and completeness, conducting audits, and coordinating with clinical staff to improve documentation. Candidates should have a...Senior
$86.4k - $96k
..., rich benefits, and values of respect, integrity, collaboration, inclusivity, and accountability... ..., and guiding and reviewing staff auditors' work to ensure quality and timely... ...requirements and organizational impact 7. Provides regular updates to Internal Audit Division...SeniorWork at officeImmediate start$29 - $34 per hour
...concrete suppliers, is part of CRH. CRH is the leading vertically integrated supplier of asphalt, aggregates, cement, ready-mix concrete,... ...America. Our 24,100 employees at 1,300 operating locations provide our customers with top-quality, innovative products and services...SeniorHourly payTemporary workLocal area$90k - $115k
...due to steady client growth. This opportunity offers strong exposure to middle-market clients across a variety of industries while providing a collaborative environment with clear advancement potential.The firm values work-life balance, professional development, and...SeniorLocal area- ...including patient access, coding, Clinical Documentation Improvement (... ...complex issues, engage senior leaders, and drive consensusExposure... ..., and curiosity, we'll provide the resources, mentorship, and... ...unwavering commitment to ethics and integrity. We not only encourage...SeniorApprenticeshipEasy work
$98.35k - $115.7k
...all from Day One.Job DescriptionThe Corporate Audit Services Senior Auditor (Corporate Treasury) is primarily responsible for completing... ...30 worked, up to 80 hours per calendar year unless otherwise provided by lawReview our full benefits available by employment status...SeniorFull timeWork at officeLocal area3 days per week- ...collaborate with leading solution providers and leverage your experience in... ...solutions.Work You’ll DoAs a US Delivery Senior Consultant, Configuration and Integration Solutions on the team, you will... ..., including invoice processing, payments, GL transfers, PO matching, POET...SeniorWork at officeLocal areaRelocationNight shift
- ...Senior Auditor I/II - Retail and Institutional Location US-MS, AL, Houston, TX; Memphis, TN; Panhandle FL; Atlanta, GA | US... ...appropriately challenging risks, scope, and approaches, and providing thoughtful recommendations. Identify and communicate potential...SeniorFull time
$91.1k - $143.6k
...environment? As an experienced Integration Engineer you will have the... ...stakeholder management in complex clinical environments. The wage range... ...Deloitte is committed to providing reasonable accommodations for... ...From entry-level employees to senior leaders, we believe there’s...Senior- As a Senior Payments Operations Analyst , this role is accountable for the stability, scalability, and risk integrity of payment operations. The position focuses on optimizing end‑to‑end... ...business decision‑making. What You'll Do Provide oversight and quality control for...SeniorLocal area
- ...Senior Auditor Employment Type: Full Time, Mid-level CGS is seeking a Senior Auditor who will assist the district legal staff by conducting... ...financial records for purposes to include identifying payments and kickbacks, tracing money flows, identifying assets,...SeniorFull timeRemote workFlexible hours
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