- Evaluate the medical necessity of claims to ensure accurate processing.
- Utilize advanced clinical knowledge to assess the appropriateness of services provided.
- Hello: Assist in complex claim reviews, making informed recommendations based on clinical experience.
healthcare claims auditor - Rio Rancho - beBeeClinicalReview
Job title: Clinical Review Nurse
Description
Key Responsibilities:
Premium Audit Associate
1 month ago
The Premium Audit Associate will conduct voluntary audits and review physical audits in addition to providing technical help and guidance to our stakeholders including Agents Insureds and other company personnel. ...
Remote Pro Fee Auditor/Educator
6 days ago
We are hiring a skilled Remote Pro Fee Auditor/Educator to join our team at Presbyterian. This is a full-time job that requires minimal supervision. · ...
RN - Nurse Auditor - HCC Program Management
1 month ago
This position performs clinical audit/validation processes to ensure medical record documentation and diagnosis coding for services rendered to Medicare Managed Care Product members is complete, compliant and accurate. · ...
Remote Pro Fee Auditor/Educator
1 month ago
We are hiring a Remote Pro Fee Auditor/Educator who will support the Coding and documentation quality assurance (CDQA) team with minimal supervision. · ...
Remote Hybrid Pro Fee Auditor/Educator
1 month ago
We are seeking a Remote Hybrid Pro Fee Auditor/Educator who will support the Coding and documentation quality assurance (CDQA) team with minimal supervision. · ...
Coder-Healthcare Fraud Investigator
1 month ago
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services · Build your Career. Make a Difference. Presbyterian is hiring a skilled Fraud Investigator to join our team. · ...
Medical Coding Analyst Auditor
3 weeks ago
We are hiring a Medical Coding Analyst Auditor - Educator to join our Coding Department at UNM Medical Group Inc. · This is a remote full-time day shift opening located in New Mexico. · ...
Medical Coding Analyst Auditor
1 month ago
This opportunity is a REMOTE, full-time position. Reporting to Manager, Medical Coding responsible for the quarterly medical coding audits and monthly educational sessions. Works closely with the Coding Supervisors Manager and Director to identify areas and make recommendations f ...
Medical Coding Analyst Auditor
1 month ago
We are hiring for a Medical Coding Analyst Auditor - Educator to join our Coding Department. · This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico. · ...
Remote Hybrid Pro Fee Auditor/Educator
1 month ago
We are hiring a skilled Remote Hybrid Pro Fee Auditor/Educator to join our team at Presbyterian Healthcare Services. · ...
Remote Pro Fee Auditor/Educator
1 month ago
We are hiring a skilled Remote Pro Fee Auditor/Educator to join our team. · Responsibilities include implementing and compliance to enterprise-wide coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; · Demonstrates hi ...
RN - Nurse Auditor - HCC Program Management
1 month ago
Job summaryA Nurse Auditor performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered to Medicare Managed Care Product members is complete, · compliant and accurate to support optimal Medicare reimbursement. ...
Premium Auditor
1 month ago
+The Premium Auditor is responsible for conducting workers compensation premium audits both remotely and at the insured's location or independent accounting firm in a timely and cost-effective manner. · ...
Medical Coding Analyst Auditor
1 month ago
Reporting to Manager, Medical Coding, responsible for the quarterly medical coding audits and monthly educational sessions for the UNM Medical Group, Inc., Medical Coding Analysts. · ...
Coder-Healthcare Fraud Investigator
1 month ago
Build your Career. Make a Difference. Presbyterian is hiring a skilled Fraud Investigator to join our team. · ...
Premium Audit Associate
1 month ago
The Premium Audit Associate will conduct voluntary audits and review physical audits in addition to providing technical help and guidance to our stakeholders including Agents, Insureds, and other company personnel. · ...
Senior Financial Consultant
2 weeks ago
The Senior Financial Consultant will be a member of the Native American consulting group, delivering fiscal management support services and assists in developing and maintaining effective fiscal management systems to our Native American Tribal clients. · The position reports to t ...
Financial Specialist Sr
1 month ago
The Second Judicial District Court is recruiting for a full-time Financial Specialist Sr. The working days/hours are Monday through Friday: 8 am - 5 pm. · Acting under general supervision perform a full range of accounting and fund management functions. · ...
Premium Audit Associate
1 month ago
The Premium Audit Associate will conduct voluntary audits and review physical audits in addition to providing technical help and guidance to our stakeholders including Agents, Insureds, and other company personnel. · High school diploma or equivalency. · Some secondary education ...
postion open for internal applicants only
1 month ago
The Bernalillo County Metropolitan Court is recruiting for a full-time Court Financial Manager 2 # in the Finance Division. · Responsible for fiscal management of the Court; supervise financial operations; train... · ...
Chief Financial Officer
2 days ago
Are you ready to make a profound impact by guiding the financial future of a mission-driven organization? · ...
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Premium Audit Associate
Full time Only for registered members Albuquerque
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Remote Pro Fee Auditor/Educator
Only for registered members Albuquerque, NM
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RN - Nurse Auditor - HCC Program Management
Only for registered members Albuquerque, NM
-
Remote Pro Fee Auditor/Educator
Only for registered members Albuquerque, NM
-
Remote Hybrid Pro Fee Auditor/Educator
Only for registered members Albuquerque, NM
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Coder-Healthcare Fraud Investigator
Only for registered members Albuquerque, NM
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Medical Coding Analyst Auditor
Only for registered members Albuquerque
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Medical Coding Analyst Auditor
Only for registered members Albuquerque
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Medical Coding Analyst Auditor
Only for registered members Albuquerque
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Remote Hybrid Pro Fee Auditor/Educator
Only for registered members Albuquerque
-
Remote Pro Fee Auditor/Educator
Only for registered members Albuquerque
-
RN - Nurse Auditor - HCC Program Management
Only for registered members Albuquerque
-
Premium Auditor
Only for registered members Albuquerque
-
Medical Coding Analyst Auditor
Only for registered members Albuquerque, NM
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Coder-Healthcare Fraud Investigator
Only for registered members Albuquerque
-
Premium Audit Associate
Only for registered members Albuquerque
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Senior Financial Consultant
Only for registered members Albuquerque
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Financial Specialist Sr
Only for registered members Albuquerque, NM
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Premium Audit Associate
Only for registered members Albuquerque, NM
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postion open for internal applicants only
Only for registered members Albuquerque, NM
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Chief Financial Officer
Only for registered members Albuquerque, NM