Medical Auditor/ Medical claims Auditor
Found in: Careerbuilder One Red US C2 - 2 weeks ago
Under the direction of the Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims payment system and processes by auditing claim payments using standard principles and State and Federal regulations. The auditors are also responsible for documenting and reporting findings and ensuring appropriate actions have been taken to resolve payment issues with the affected departments within IEHP, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
CalPERS retirement.
Medical Insurance with Dental and Vision.
Life, short-term, and long-term disability options
Flexible Spending Account – Health Care/Childcare
CalPERS retirement
Four (4) years auditing claims in a managed care environment including contract and financial DOFR interpretation.
Two years (2) claims processing including Medi-Cal and Medicare.
Knowledge of Medi-Cal and CMS guidelines for claim payments.
Must be able to review cause and impact of problems and recommend realistic solutions both in writing and in meetings. Microsoft Office including being able to manipulate large data sets in Excel files.
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Claims Oversight Auditor
1 week ago
Rancho Cucamonga, United States Inland Empire Health Plans Full timeWhat you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...
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Claims Oversight Auditor
Found in: beBee S US - 2 weeks ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of the Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...
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Claims Oversight Auditor
1 week ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of the Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...
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Medical Claims Auditor
Found in: Jooble US O C2 - 2 weeks ago
City of Industry, CA, United States Innovative Management Systems Incorporated Full timeThis position is responsible for reviewing and processing claims, including facility claims, to ensure accuracy prior to payment release. This position is the lead responder to Health Plans and IMS Clients for all products and lines of business. Responsible for management and monitoring of claims compliance with all products and lines of business for managed...
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Auditor - Provider Recovery
1 week ago
Rancho Cucamonga, United States Experis Full timeTitle: Auditor - Provider Recovery Location: Rancho Cucamonga, CA (HybridTues, Wed, And Thursday onsite. Mon/Friday (remote)) Duration: 6-month contract Rate Range: $25 to $30/hr. on W2. Responsibilities:Summary Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit...
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Compliance Auditor III
Found in: beBee S US - 1 week ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeFind joy in serving others with IEHP!We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program.The Compliance Auditor III is responsible for conducting...
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Compliance Auditor III
Found in: beBee jobs US - 2 weeks ago
Rancho Cucamonga, California, United States Inland Empire Health Plan Full timeFind joy in serving others with IEHPWe welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experienceThe Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program.The Compliance Auditor III is responsible for conducting compliance audits,...
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Compliance Auditor I
7 days ago
Rancho Cucamonga, United States CareerBuilder Full timeWhat you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the general supervision of the Compliance Audit & Oversight Manager, the Compliance Auditor I conducts and assists with compliance audits and supports initiatives...
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Physician Billing Auditor, Medical Records
Found in: Jooble US O C2 - 3 days ago
Sacramento, CA, United States Cedars-Sinai Full timeJob Description What will I be doing in this role? The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or...
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Compliance Auditor
1 week ago
Rancho Cucamonga, United States National Community Renaissance Full timeJob DescriptionJob Description"Together, we transform lives and communities!"National Community Renaissance (CORE) is seeking qualified individuals to join our team. CORE is one of the nation's largest non-profit affordable housing developers with a 30-year track record in community revitalization. We transform the economic and social future of...
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PHARMACEUTICAL AUDITOR
Found in: Careerbuilder One Red US C2 - 6 hours ago
, IL, United States SQA Services Full timeSQA Services is a leading Quality Assurance and Supply Chain consultancy firm. SQA manages Supplier Audit and Supplier Development programs for customers in many industries including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients leverage SQA's network of Quality Professionals in more than 50 countries as an...
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QUALITY AUDITOR
Found in: Careerbuilder One Red US C2 - 5 hours ago
, CA, United States SQA Services Full timeSQA is a leading Quality Assurance and Supply Chain solutions firm. SQA manages Supplier Audit and Supplier Development programs for clients in quality-critical industries, including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients leverage SQA's network of Quality Professionals in more than 90 countries as an...
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Financial Compliance Auditor
1 week ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and oversight of IEHPs...
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Financial Compliance Auditor
1 week ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and oversight...
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Financial Compliance Auditor
3 days ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeOverview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and oversight...
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NIGHT AUDITOR
Found in: Careerbuilder One Red US C2 - 6 hours ago
, OR, United States Sonesta International Hotels Corporation Full timeThe Night Auditor (NA) is responsible for accurately balancing all hotel income and expenses for every 24 hour hotel operating period. The NA also acts as a Guest Service Agent for the overnight front desk shift at the hotel. The NA is responsible fo Night Auditor, Auditor, Guest Service, Operations Manager, Audit, Accounting
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Sr. Physician Coding Compliance Auditor
Found in: Careerbuilder One Red US C2 - 1 week ago
Arco Plaza, CA, United States CEDARS-SINAI Full timeJob DescriptionWhat will I be doing in this role?The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks...
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Financial Compliance Auditor
4 days ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeOverview:What you can expect!Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience!Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and oversight of...
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Auditor III
7 days ago
Rancho Cucamonga, United States CareerBuilder Full timeWhat you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of the Internal Controls Manager, the Internal Controls Auditor III is responsible for conducting internal audits and reporting results identifying...
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NIGHT AUDITOR
Found in: Careerbuilder One Red US C2 - 5 hours ago
, MD, United States Crestline Hotels & Resorts, Inc. Full timeThe Front Desk Night Clerk will serve as ambassador to the hotel handling all check-in and check-outs, answering incoming calls while upholding Guest Service Standards. Functions will also include nightly accounting and working as a Runner for hous Night Auditor, Auditor, Night Clerk, Property Management, Audit, Accounting