Healthcare Compliance & Fraud Auditor
NACBA
CVS Health is seeking a Program Integrity Auditor to review medical, behavioral, transportation, and other healthcare provider records to ensure accurate coding and proper documentation. The role involves audits across Medicaid lines of business and may lead to follow-up actions including education, recoupment, or referrals for suspected FWA. Responsibilities include coordinating audit reports, identifying unusual billing patterns, and assisting with regulator deliverables while ensuring #J-18808-Ljbffr NACBA
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Healthcare Compliance & Fraud Auditor in Florida, NY vacancy
- Molina Healthcare in Florida is seeking a Medicaid Claims Examiner to support adjudication, review claims for coding accuracy, identify fraud and overpayments, and manage a caseload with supporting records. Ideal candidates have at least 2 years of Medicaid claims experience...FraudWork at office
$100k
...control prevention industry since 1945 and is seeking a Premium Auditor as we continue to grow our team. Premium Auditors examine... .... As a premium auditor, you will look for evidence of fraud and verify compliance. Your job will be based from home, with required daily...FraudWeekly payLocal areaRemote workWork from homeHome office2 days per week3 days per weekARM Strong Receivables Management, Inc.
Florida, NY2 days ago- A leading healthcare consulting firm is seeking a 340B Auditor to join their audit team in New York. The role involves conducting external audits, collaborating with analysts, and ensuring compliance with 340B program regulations. Candidates should have at least 3 years...Suggested
- Memorial Healthcare System is seeking an experienced Coding Auditor in Florida to ensure compliance with medical coding and billing standards. This role involves auditing physician evaluations and procedures and preparing reports for executive leadership. The ideal candidate...Suggested
$54.92k - $107.1k
Molina Healthcare is seeking a Compliance Auditor to support compliance auditing activities. The role involves evaluating adherence to regulatory requirements, identifying compliance gaps, and recommending improvements to mitigate risks related to fraudulent practices....Suggested$80k - $90k
...now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment... ...not limited to information security, anti-harassment and other compliance and policy/procedures training applicable for position.* Proactively...Remote workFlexible hoursPerformant
Florida, NY1 day ago- ...Alliance for Career Enhancement seeks a Sr. Analyst for Fraud, Waste, and Abuse (FWA) specifically in healthcare services. This full-time position involves... ...collaborating with various departments to ensure compliance and training. Ideal candidates will have 3-5 years...FraudFull time
$14.9 - $29.06 per hour
Molina Healthcare in California seeks a Senior Claims Examiner to provide support for claims examination, focusing on evaluating claims for coding errors and fraud. You will manage a caseload and ensure compliance with state and federal regulations while maintaining meticulous...FraudHourly payWork at office$67.98k - $106.21k
...service focus. Active BLS certification for healthcare professionals from the American Heart... ..., and local regulations, including fraud and abuse prevention. Adhere to company... ...employment and will participate in ongoing compliance with the Drug‑Free Workplace Policy. Employees...FraudLocal areaImmediate startNight shiftChapters Health System
Florida, NY3 days ago- ...Document collection activities and outcomes in compliance with company policies. Support... ...Experience Minimum 3 years of experience in healthcare collections or revenue cycle operations.... ...Insurance MetLife Legal, MetLife ID Fraud, and MetLife Pet Insurance 401(k) #J-188...FraudTemporary workFlexible hours
Abbott
Florida, NY1 day ago - ...in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient... ..., and continuous improvement in healthcare operations. Duties & Responsibilities... ...Identify coding discrepancies, potential fraud, and quality concerns Provide training,...FraudFull timeWork at officeRemote workWork from homeHome office
$46.99k - $122.4k
...Summary The Program Integrity Auditor is responsible for the review... ..., transportation, and other healthcare providers. The Auditor must have... ...regulators for any suspected fraud, waste, or abuse (FWA). The... ...rules. Maintain compliance with company policies and procedures...FraudHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursNACBA
Florida, NY2 days ago- ...for providing a full range of financial, compliance, and operational audits, business... ...function and the corporation. Serve as Lead Auditor on more complex audit assignments. Draft... ...deficient controls, duplicated effort, fraud, or non‑compliance with laws, regulations...FraudFor contractorsWork at office
$100k
...industry since 1945 is seeking a Premium Auditor to grow our team. Premium Auditors... ...responsibilities will be looking for evidence of fraud and checking that insured businesses... ...documentation Identify discrepancies and ensure compliance Prepare and submit audit reports Job...FraudHourly payWeekly payLocal areaWork from homeFlexible hours- ...closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in... ...findings, ensuring accuracy and compliance with legal and regulatory requirements.... ...providing training and support to other auditors/investigators, contributing to the continuous...FraudWork experience placement
- ...Assists Management with the Company’s ongoing compliance with the Sarbanes‑Oxley Act by performing... ...of operational efficiencies, fraud investigations and evaluation of newly acquired companies. Assist external auditors, as required Interview personnel to ascertain...FraudRemote work
Chesapeake Utilities
Florida, NY2 days ago - Evestia Clinical is seeking a Quality Assurance Auditor II to ensure compliance through various audits, including site audits and internal process audits. This position involves working under limited supervision and requires a strong background in clinical trials, GCP experience...Flexible hours
- Overview Vice President, Auditor, Operations and Payments At BNY, our culture allows us... ...payment processing, cash management and fraud prevention. Oversee end-to-end audit delivery... ...effectiveness. Regulatory & Policy Compliance: Ensure audits address key regulatory frameworks...FraudWorldwideFlexible hours
- ...and bank deposits. 5. Verify gasoline inventory by sticking tanks and checking for water. 6. Performs various surveys to verify compliance with operational and financial procedures. 7. Works in safe manner by complying with procedures, rules and regulations. 8. Able to...Local areaNight shift
Circle K Stores Inc.
Florida, NY3 days ago - We are in search for a Compliance Specialist. Compliance works to ensure controls and safeguards are in place to promote adherence to applicable... ...informed of applicable rule and regulation changes in the healthcare and pharmaceutical industries Assists in the day-to-day...Temporary workWork at officeLocal areaImmediate startFlexible hours
- ...JOB SUMMARY The Senior Auditor – IT Audit Focus participates in all critical aspects of delivering independent audit assurance services... ...controls, data management, and supporting operational and compliance processes. The Senior Auditor will also contribute to the continued...
Seacoast Bank
Florida, NY1 day ago $57.79k
The Auditor position is a full-time (40 hours) remote position with a flexible schedule... ...external timely operational, financial, and/or compliance audits of divisions, departments,... ...deficient controls, duplicated effort, fraud, or non-compliance with laws, regulations...FraudFull timeFor contractorsWork at officeLocal areaRemote workFlexible hours- ...policies for insurance companies. You will schedule appointments, perform field audits, and examine financial records to ensure compliance and accuracy. Ideal candidates have strong verbal communication, accounting knowledge, and the ability to work independently with...
- Circle K Stores Inc. in New York is looking for an Inventory Auditor to verify merchandise and cash across company stores. The role... ...physical counts, notifying managers of inaccuracies, and ensuring compliance with operational procedures. Candidates should possess a high...Night shift
- ...coding guidelines, medical necessity and compliance with regulatory requirements.... ...compliance with regulatory agencies governing healthcare delivery, third party payers, and accrediting... ...(AHIMA), Certified Professional Medical Auditor (CPMA) - American Academy of...Work experience placementWork at officeShift work
- Evestia Clinical Group seeks a Quality Assurance Auditor II in Florida, NY, to conduct compliance audits across clinical trials. The role demands GCP experience, strong auditing skills, and a degree in bio-sciences. Join a team dedicated to innovation and excellence, with...
$75k
ARM Strong Receivables Management, Inc. is seeking a Premium Auditor to conduct audits for insured businesses and ensure compliance with regulations. You will primarily work from home, but travel to client locations is required. Candidates should have a background in auditing...Remote jobWork from homeFlexible hours- ...Town of Florida, NY. Responsibilities include verifying merchandise and cash, notifying management of discrepancies, and ensuring compliance with operational procedures. A high school diploma or GED is preferred, along with some retail experience. The role might also...Night shift
$70.1k - $126.2k
...Under the general direction of the VP of Compliance Investigations this position assists... ...compliance investigations in a regulated healthcare environment preferred. Experience collaborating... ...Licenses and Certifications Certified Fraud Examiner (CFE) preferred. Certified...FraudFull timePart timeWork at officeRemote workFlexible hours$88k - $132k
...functional and technical discussions and is motivated to design scalable, future‑proof solutions that support business growth and compliance. Job Description And Requirements Who We Are Relativity is a leading legal data intelligence company building technology that...Remote workHome officeRelativity
Florida, NY1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Compliance & Fraud Auditor. Be the first to apply!
Related searches