- Cedars-Sinai (CA)
- …in Healthcare or related field of study, preferred. **Req ID** : 7494 **Working Title** : Claims Auditor ( Managed Care ) - Remote **Department** : MNS ... we strive for. **What will you be doing:** The Claims Auditor is responsible for ensuring the...Managed Care **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more
- LA Care Health Plan (Los Angeles, CA)
- … claims audits or claims processing related to Medi-Cal, Cal MediConnect, and/or other managed care product lines similar to LA Care 's, LA Care ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance...$115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... compliance with state and federal requirements and also LA Care contractual agreements. The position handles DMHC claims...discrepancies prior to DMHC filing. Responds to Department of Managed Health Care (DMHC) questions regarding data… more
- AmeriHealth Caritas (Philadelphia, PA)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping...communicate the audit outcome to the appropriate persons. The auditor will validate production to ensure that the case… more
- Tennessee Comptroller of the Treasury (Nashville, TN)
- …financial, and budgeting support to the Division of TennCare + Examining TennCare Managed Care Contractors (MCCs), who contract with the state to provide ... Auditor : Financial/TennCare This role focuses on examining, analyzing,...focuses on examining, analyzing, and reviewing records, financial statements, claims data, and cost reports for providers participating in… more
- Covenant Health Inc. (Knoxville, TN)
- …Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers ... spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- Healthfirst (NY)
- …records review; claims processing; utilization/case management in a clinical practice or managed care organization; managed care plan products (eg ... of Social Services and Center for Medicare &Medicaid Services(CMS) regulations pertaining to managed care ; nursing experience in an acute, sub-acute or long-term… more
- Molina Healthcare (Warren, MI)
- …of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- AIG (Jersey City, NJ)
- …work and live. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants ... of everything we do, from underwriting risks to processing claims . The Information Technology team equips our colleagues with...Services (DNS), and multiple Quest products, such as Change Auditor and Recovery Manager. In this role, you will… more