Managed Care Auditor Jobs (NOW HIRING)

Minimum of five years experience in insurance, medical or managed care environment including two years of claim processing experience required. Previous auditing and/or Amisys experience preferred.

Minimum of five years experience in insurance, medical or managed care environment including two years of claim processing experience required. Previous auditing and/or Amisys experience preferred.

Minimum of five years experience in insurance, medical or managed care environment including two years of claim processing experience required. Previous auditing and/or Amisys experience preferred.

Minimum of five years experience in insurance, medical or managed care environment including two years of claim processing experience required. Previous auditing and/or Amisys experience preferred.

Maintains an expanded knowledge base CPT-4 and ICD-10 codes, government, managed care and third ... Auditing experience required. * AAPC CPC Certification required. * Healthcare (professional ...

Essential Job Duties Performs audits in utilization management, care management, member assessment ... Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ...

Contract & Data Analyst (Managed Care) Direct Hire | Full-Time | Onsite Schedule: Monday - Friday ... Someone comfortable auditing payor performance and identifying revenue recovery opportunities. * A ...

... Care Management and Community Supports (ECM/CS), and Grievance and Appeals (G&A). The auditor ... evaluates compliance with established management control systems, policies, procedures, and ...

... Care Management and Community Supports (ECM/CS), and Grievance and Appeals (G&A). The auditor ... evaluates compliance with established management control systems, policies, procedures, and ...

Company Description Are you an experienced Certified Coder with Managed Care experience looking for ... Medical Coding Auditor Position Summary: As the Medical Coding Auditor, you would be responsible ...

This role drives profitability through advanced contract modeling, proactive performance auditing, and collaboration with leadership to align managed care strategies with organizational growth ...

Oversees, in conjunction with the Managed Care Management Team, to ensure QA programs are aligned ... Claims auditing and understanding claims processing in a claims department identifying compliance ...

Claims Auditor will be responsible for auditing claims processed by Claims Examiners ... managed care industry Must be familiar with ICD-10, HCPCS, CPT coding, APC, ASC, and DRG pricing.

Identifies and notifies management of observed quality and communicates opportunities for process ... Integrates healthcare auditing principles and uses objectivity in performance of medical audit ...

Dental Auditor Department: Quality Management (QM) Position Type: Full-time Compensation: $600 per ... Minimum 2 years of experience working with dental plans (payer, DSO, or managed care setting)

Dental Auditor Department: Quality Management (QM) Position Type: Full-time Compensation: $600 per ... Minimum 2 years of experience working with dental plans (payer, DSO, or managed care setting)

Essential Job Duties • Performs audits in care management, member assessment, behavioral health ... auditing approaches follow a Molina standard in approach and tool use. • Maintains member ...

Performs and provides oversight to the Managed Care Plan's (MCP) Department of Health Care Services (DHCS) auditing team responsible for conducting and overseeing both initial and subsequent reviews ...

Experienced Medical Auditor Knowledge of Medical Records and codingPreferred: Prior Customer ... managed care patient accounting principals, Proficient understanding of medical terminology ...

Job Summary Help Strengthen Healthcare Operations Through Risk and Compliance Reviews The ... Support audit planning, scheduling, and project execution while managing multiple assignments What ...