Senior Claims Auditor, Managed Care Compliance
Cedars-Sinai Medical Center
Cedars-Sinai in Los Angeles is seeking a Claims Auditor responsible for ensuring the accuracy of claims processing based on department policies. You will conduct audits, document findings, and provide analysis to management for errors and inconsistencies. The ideal candidate has a minimum of 4 years in claims processing and 5 years of audit experience, with a focus on compliance with state and federal regulations. Join a dynamic and inclusive environment dedicated to high-quality patient care. #J-18808-Ljbffr
- ...Cedars-Sinai Medical Center in Los Angeles is seeking a Claims Auditor responsible for ensuring the accuracy of claims processing according... ...audits, document findings, and make recommendations to management for process improvements. The ideal candidate has a High School...SeniorClaims
$325k
...application security, reliability, compliance, and cost optimization.... ...protected API calls, and helped manage $2.8B in cloud spend -... ...national origin. At Harness, we care about your privacy and are... ...unsolicited emails, or messages claiming to be from our recruiters or...SeniorClaimsLocal areaImmediate startFlexible hoursShift work- ...Senior Auditor Employment Type: Full Time, Mid-level CGS is seeking a Senior Auditor who... ...district legal staff by conducting medical claims data analysis, forensic investigations,... ..., litigation consulting, and/or health care fraud analysis required. The resume must...SeniorClaimsFull timeRemote workFlexible hours
- TradeJobsWorkForce is seeking a Risk Manager in Los Angeles, California, to lead the management and communication of company... ...involves managing insurance procurement, developing compliance policies, and handling claims and litigation. The ideal candidate will have...SeniorClaims
- ...committed to helping primary care and specialist... ...in this role? The Claims Auditor is responsible for ensuring... ...detailed audits for compliance with State, Federal... ...prepares recommendations to Management for errors and... ...preferred ~5 years of Senior/Lead or Claim Audit experience...ClaimsWork experience placementRemote work
- QBE Americas, Inc. is seeking a Senior Specialist in Specialty Claims (Aviation) to manage operational and technical aspects of Aviation Claims. This role provides... ...in handling complicated claims, ensures compliance with aviation insurance policies, and drives continuous...SeniorClaims
$215k - $235k
...paradigm from reactive "sick-care" to proactive health... ...We are looking for a Senior Counsel - Litigation &... ...preventative health. You will manage the company's full... ..., medical malpractice claims, and employment matters... ...related to legal and compliance issues related to pending...SeniorClaimsLocal areaImmediate startFlexible hoursShift work$78.5k - $163.6k
Direct Jobs is seeking a Claims Quality Supervisor in Los Angeles to lead audit and quality... ...systems, overseeing audits, and managing the customer service team. The role demands... ...communication skills and proficiency in managed care software. The salary range is $78,500 - $...SeniorClaims- ...Subsidiaries is seeking a motivated Senior Counsel for its Global Employment Law... ...on employment-related advice, claims defense, and litigation. The ideal candidate... ...include advising on compliance with labor laws and managing legal risks. The position is located...SeniorClaims
- Summit Consulting is seeking a Claims Technical Director to manage complex excess claims in Los Angeles. The ideal candidate must have at least 15 years of experience and a degree in Business Administration or a related field. This role involves managing claim strategies...SeniorClaimsRemote work
- ...support the department in achieving risk management program goals for the organization. Key duties... ...include initiation and review of new claims in the Event Reporting System; grievances... ...Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded...ClaimsWork experience placement
$117.51k
...Established in 1997, L.A. Care Health Plan is an... ...Job Summary Manager, Financial Compliance Audit (Finance) has a... ...cross-functional teams, senior leadership, and delegates... ...to assign the annual claim processing and... ...Certified Internal Auditor (CIA) Certified Management...ClaimsWork at officeRelocation package$85k
...a Dental Practice Operations Manager to join our practice Santa Monica... ...mission to elevate patient care, streamline operations, and... .... Audit daily workflows for compliance and consistency with Imagen policies... ...patient credits, refunds, claims, and cash deposits are...ClaimsDaily paidWork at officeLocal areaRelocation package$170k - $281.86k
...Internal Audit & Risk Senior Manager Are you interested in joining one of the fastest growing... ...of risk, governance, internal audit, compliance, IT, and cybersecurity best practices.... ...clients, teammates and leadership who truly care about you and your development. Does...SeniorWork experience placement- .... The role includes managing client relationships, overseeing... ...projects for health care clients, ensuring... ...as a trusted advisor to senior stakeholders Oversee... ...efficiency, regulatory compliance, digital transformation... ...of Member, Provider, Claims, UM/CM/DM, Customer Service...SeniorClaimsRemote work
- MedPOINT Management is seeking a Hospital Claims Auditor responsible for ensuring the quality of claims processes and compliance with health plan and hospital regulations. The role involves auditing... ...years of experience in managed care claims adjudication. Key skills...ClaimsRemote work
- ...with account knowledge as it relates to hazards, controls, and management. They will need to evaluate how a company identifies and manages... ...Build and maintain productive relationships with Underwriting, Claim, Risk Control Specialists, and Brokers to service customers as...SeniorClaimsFor contractorsLocal areaLong distanceNight shift
- ...Analyst/h2pWe are seeking a Senior Business Analyst to... ...as Florida Community Care and Florida Complete Care... ...IT professionals, and management to gather requirements... ...met while maintaining compliance and improving overall service... ...of UB04 / CMS-1500 claim adjudication process, including...SeniorClaimsDaily paidContract work
- ...Job Title Senior Financial Analyst Job Description... ...standard of patient care we strive for. What... ...operations and management. Responsibilities include... ...managed care contracts for compliance and financial... ...health records (EHR), claims data, and health information...SeniorClaimsContract workShift work
$93.76k - $161.74k
...Details The Business Change Manager Senior - Payment Integrity is responsible... ...experience within a managed care/healthcare organization and... ...base of regulatory and compliance regulations. Significant experience... ...Integrity and healthcare claims experience. Candidates from...SeniorClaimsWork experience placementWork at officeLocal area2 days per week1 day per week- ...We’re a team of fast‑paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses...SeniorClaimsFull timeLive outWork at officeLocal areaRemote workFlexible hours
$117.51k
...Senior Manager, Claims Adjustments Job Category: Management/Executive Department: Claims Integrity... ...00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public... ...audit readiness. Partners with Compliance to validate adherence to regulatory standards...SeniorClaimsFull timeContract work$200k - $288k
...Aon is looking for a Senior Project Risk Advisor to join our Construction... ...a visible leadership role in managing large, sophisticated, and... ...Coordinate closely with Broking, Claims, Analytics, Risk Capital, and... ...savings account, health care and dependent care reimbursement...SeniorClaimsFull timeTemporary workPart timeFor subcontractorWork at officeLocal area$325k
...Senior Enterprise Account Executive - Socal Los Angeles, California... ...security, reliability, compliance, and cost optimization. Harness... ...API calls, and helped manage $2.8B in cloud spend enabling... ...unsolicited emails, or messages claiming to be from our recruiters or...SeniorClaimsLocal areaImmediate startFlexible hoursShift work- ...aptitudes but also who care deeply about EVERSANA,... ...Science Liaison/Senior Medical Science Liaison... ...are involved with the management and treatment of CTCL.... ...SOPs and ensure vigilant compliance with relevant legal and... ...or even text messages claiming to be a legitimate company...SeniorClaimsLocal areaNight shift
- ...Job Description The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring... ...including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining...ClaimsContract work
$84.07k - $163.93k
Molina Healthcare seeks a Healthcare Manager in Los Angeles, CA, to lead multidisciplinary teams in care management and compliance with state and federal regulations. The ideal candidate has over 7 years in healthcare, including 3 years in managed care, and holds an active...Senior$104.8k - $128k
Disney is seeking a Sr SOX IT Analyst to support IT SOX compliance activities focusing on financial reporting. Responsibilities include executing SOX audits, collaborating with business stakeholders, and evaluating control effectiveness to identify risks. The ideal candidate...Senior$150k - $175k
Senior Director of Enterprise Risk & Legal Operations... ...an experienced risk management leader with a strong track... ...legal, insurance, and compliance requirements into... ...Support legal strategy for claims, regulatory issues,... ...information, family care, marital status, enrollment...SeniorClaimsFull timeContract workSummer workInternshipWork at officeWork from homeMonday to FridayWeekend workAfternoon shift$88k - $132k
...Job Overview ABOUT THE ROLE The Senior Financial Systems Analyst serves as the... ...solutions that support business growth and compliance. Job Description and Requirements... ...legal AI software to securely surface and manage the most relevant and impactful information...SeniorRemote workHome office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Claims Auditor, Managed Care Compliance. Be the first to apply!
- safety auditor Los Angeles, CA
- field auditor Los Angeles, CA
- remote auditor Los Angeles, CA
- pharmacy auditor Los Angeles, CA
- sox auditor Los Angeles, CA
- medical claims auditor Los Angeles, CA
- energy auditor Los Angeles, CA
- remote nurse auditor Los Angeles, CA
- revenue auditor Los Angeles, CA
- coding auditor Los Angeles, CA


