Claims Auditor - Whittier, CA

We are seeking an experienced Claims Auditor / Claims Processor to support our Claims Department. This role requires strong medical claims processing experience and knowledge of HMO/IPA operations, Medicare, and Medi-Cal guidelines. · Evaluate patient protected health information ...

The Claims Auditor assists in the Claims Department by analyzing procedures,policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. · Safeguards and preserves the confidentiality of patient's protected health information in a ...

The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. · ...

The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. · Safeguards and preserves the confidentiality of patient's protected health information in ...

The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. · Formal training will be indicated by a high school diploma or equivalent; · four years med ...

The Claims Auditor will be responsible for the accurate review and auditing of claims that are adjudicated by the system and the Claims Examiners. · At AltaMed, your passion for helping others isn't just welcomed – it's nurtured, celebrated, and promoted, allowing you to grow whi ...

Job Description: · The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. · COMMUNICATION · Talking or hearing essential to communicate with patien ...

The Specialty Health Plans Auditor III, · Claims is responsible all aspects of planning, · execution, reporting, and corrective action · plans monitoring of claims processing compliance · for specialty health plans and vendors.Performs annual claims audits for Specialty Health Pl ...

The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting. · Performs annual claims audits for Specialty Health Plans and vendors. · ...

We are currently seeking a highly motivated Senior Claims Auditor.This role will report to the Director - Claims and enable us to continue to scale in the healthcare industry. · ...

We are currently seeking a highly motivated Senior Claims Auditor. This role will report to the Director - Claims and enable us to continue to scale in the healthcare industry.Audit & OversiteAnalyze and audit Health plan claims selections for all health plan/DMHC/CMS auditsRevie ...

About Us · All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients.  ACTY is a modern growing company which encourages diver ...

A leading healthcare organization in West Hills is seeking a Claims Examiner with strong claims compliance auditing experience. · Audit claims (especially denials) and support resubmission workflows · Contribute to benefit analysis and system design inputs impacting claims operat ...

A leading healthcare organization in West Hills is seeking a Claims Examiner with a strong claims compliance auditing experience (preferred). You'll analyze denials, support benefit analysis and system design considerations, manage special projects, and help improve auto‑adjudica ...

++A Medical Claim Lead Auditor will lead client audits, review discrepancy issues and draft final reports. The role involves team leadership, client management and audit project management. · ++Conduct pre-implementation and coverage specific audits · Review documentation of pot ...

The Claims Quality Auditor II works closely with the Claims Quality Auditing Manager to ensure claims are being processed per regulatory guidelines. · This position conducts audits of high dollar claims, Provider Disputes and Adjustments.Maintains up-to-date knowledge of current ...

The Claims Quality Auditor II works closely with the Claims Quality Auditing Manager. This position serves as a liaison between partnering departments i.e. Payment Integrity and Claims Compliance.This position works to ensure claims are being processed per regulatory guidelines a ...

A Medical Claim Field Auditor applies medical claims audit experience to perform self-insured client audits. · ...

The Claims Quality Auditor II works closely with the Claims Quality Auditing Manager and maintains up-to-date knowledge of current trends and issues in healthcare. · ...

The Financial Compliance Auditor III, Claims is responsible for various tasks within the Financial Compliance Unit. This role works closely with the Supervisor and/or Lead Auditor on the identification and resolution of issues in a timely and efficient manner. · A minimum of 5 ye ...