Medicare Grievance & Appeals Auditor I
Solis Health Plans, Inc.
Solis Health Plans, Inc. in Doral, FL, is seeking a Grievance & Appeals Auditor I to perform end-to-end audits of member appeals and grievances, ensuring CMS compliance and timely resolutions. You will review case files, validate review levels, and help identify opportunities for process improvement while supporting regulatory examinations. This role emphasizes attention to detail and collaboration with clinical reviewers and compliance teams. #J-18808-Ljbffr Solis Health Plans, Inc.
$87.5k
...provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the... ..., Twitter and LinkedIn. Brief summary of purpose: The SIU Code Auditor will conduct coding audits of medical records provided by...SuggestedLocal area$68k - $90k
...Coaches coding and billing specialists on proper and compliant appeal preparation. May prepare appeals as needed Researches coding... ...Familiarity with third part billing policies and procedures including Medicare/Medicaid, Managed Care, No-Fault and Workers' Compensation...Suggested$59.3k - $80.9k
...come in Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records... ...efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel...SuggestedBi-weekly payContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...Description Summary:**ModMed is hiring a driven **Medical Coding Auditor** to join our positive, passionate, and high-performing BOOST... ...compliance or client documentation issues* Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits* Assist...SuggestedWork at officeLocal areaRemote workFlexible hours
$34.29 per hour
...Network Job Description : GENERAL OVERVIEW: Senior most coding auditor who evaluates medical records to determine the accuracy of... ...entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Interacts with...SuggestedFor contractorsLocal area- ...Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG... ...payer rules and regulations, including Medicare and Medicaid Understand and comply with... ...Control team and medical director with appeals, rebuttals, etc. Notify leadership of any...Minimum wageFull timeWork at officeLocal areaFlexible hours
$50 - $60 per hour
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$70k - $85k
Company DescriptionFORTUNE 500 FINANCIAL SERVICE COMPANYMUST HAVE EITHER BIG 4 OR FINANCIAL SERVICE EXPERIENCEJob Description-Senior Auditor An opportunity is currently available for an experienced audit professional within our Internal Audit Department. The successful...Work at officeLocal areaNight shift- As a Technology Senior Auditor (Associate) within the Infrastructure Platforms (IP) Technology Audit team, you will play a key role in executing Infrastructure Platform audits in a dynamic, fast-paced environment. You will be responsible for leading audit testing, partnering...Visa sponsorship
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.... Internal Audit also assists in monitoring the Firm's compliance with guidelines set for risk management and risk monitoring. IT Auditors focus on the application/infrastructure controls supporting the business processes and are responsible for understanding, analyzing...$68k - $160k
Vice President, Auditor, Markets and Wealth Services At BNY, our culture allows us to run our company better and enables employees’ growth and success. As a leading global financial services company at the heart of the global financial system, we influence nearly 20% of...Temporary workWork experience placementWorldwideFlexible hours$66k - $71k
...Title: Operations Auditor Unit: Evaluation and Quality Improvement Reports to: Director of Data Integrity and Compliance Status: Full Time; Regular; Exempt Salary Range: $66,000 - $71,000 annually Location: Long Island City, Queens Days/Hours...Permanent employmentFull timeWork experience placementMonday to Friday- ...Auditor Hours: Full Time - 35 Hours Work Location: 30-30 Thomson Avenue, LIC, NY 11101 Only candidates who are permanent in the Associate Project Manager title, or those who are reachable on DDC's promotional list for exam #3573 or the open-competitive list for exam...Permanent employmentFull timeContract workH1bWork at officeVisa sponsorship
$25.15 per hour
...Description Position Summary: Conduct daily gaming and non-gaming revenue audits and complete associated checklists. Job Title: Auditor Department : Finance Reports To: Supervisor Revenue Audit FLSA Designation: Non-Exempt License Type: Gaming Target Pay: $25.15 Essential...Work at officeFlexible hours- VH Hospitality in Kentucky is seeking an overnight Front Desk Clerk to greet guests, check in/out, and manage cashiering with accuracy. You will verify reservations, promote rewards, and handle payments while maintaining a secure house bank. You must be detail oriented...Shift workNight shiftWeekend work
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$61.5k - $98.3k
About Northern Trust As a global leader in innovative wealth management, asset servicing, asset management and banking services, Northern Trust (Nasdaq: NTRS) is proud to guide the world's most successful individuals, families, corporations and institutions. Since 1889...H1bWork at officeWork from homeWorldwideFlexible hours$86k - $144k
...you. Join Swiss Re's Group Internal Audit (GIA) team and play a key role in advancing Swiss Re's resilience. About the Role As an Auditor in Group Internal Audit , you will bring your expertise across the full reinsurance end-to-end value chain, contributing to a wide...Temporary workWork at officeRelocation packageFlexible hours3 days per week- ...Safety Auditor The Department of Design and Construction, Division of Safety and Site Support seeks a Safety Auditor. The selected candidate will be responsible for overseeing all aspects of DDC's safety-related construction programs. Key duties include conducting field...Full timeFor contractorsWork experience placementLocal area
- Montgomery Personnel is seeking a field inspector to enforce revenue and licensing laws in Montgomery. You will inspect business premises, verify receipts, and ensure compliance with established policies under supervision. The role requires up-to-date Alabama driver’s ...
- Required Experience: Minimum 4 years of hospital/facility-based Inpatient Coding experience, including: Principal Diagnosis selection DRG assignment Secondary diagnosis coding Procedure coding using ICD-10-PCS Inpatient account coding and DRG assignment across Neurosurgery...
$14.76 - $31.97 per hour
...established procedures and standards. Demonstrates subject matter expertise in all business segments that require auditing (Medicaid, Medicare, Marketplace). Offers suggestions for process improvement and exceptional customer experience. Assists with the creation and...Hourly payWork experience placementWork at officeImmediate start$76.5k
...Description Job Title: Auditor I Department: Audit Services Supervisor: Director Audit Work Location: 2 Broadway, New York, NY 10004 Hours of Work: 8:00 am - 4:30 pm (7.5 hours/day, or as required) Full/Part-Time: FULL Salary: $76,498 Deadline: Until filled This position...Full timeContract workPart timeFor contractorsRemote workWeekend workAfternoon shift1 day per week
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