Medical Claims Auditor I

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 Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...

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 Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...

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 Claims Oversight Supervisor, the Internal Claims Oversight Auditor is responsible for ensuring the compliance of IEHP’s claims...

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 general supervision of the Compliance Audit & Oversight Manager, the Compliance Auditor I conducts and assists with compliance audits and supports initiatives...

Title: 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...

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!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...

Find 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,...

Job 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...

**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 department leadership, the Financial Analyst I - Financial Compliance is responsible performing analysis and preparing financial...

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! The Manager, Claims Processing - Covered California is responsible for oversight and direction of claims and auditing activities of the Covered California (CCA) vendor...

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 IEHPs...

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...

Overview: 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...

**Job Summary**: **Responsibilities**: - Review and verify accuracy of billing data and revise any errors - Prepare and submit claims to insurance companies - Follow up on unpaid claims within standard billing cycle timeframe - Utilize medical billing software to process claims - Communicate with insurance companies regarding claim denials or...

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 Internal Controls Manager, the Internal Controls Auditor III is responsible for conducting internal audits and reporting results identifying...

**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 Supervisor of Provider Data Configuration, the Analyst is responsible for managing the front-end maintenance of Provider...

Overview: **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 Supervisor of Provider Data Configuration, the Analyst is responsible for managing the front-end maintenance...

Overview: 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 Internal Controls Manager, the Internal Controls Auditor III is responsible for conducting internal audits and reporting results...

**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 general supervision, the Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and...

1. Develop and implement medical policy for utilization management activities and functions, including benefit manual statement, policies and procedures, and Utilization Management Subcommittee Guidelines. Provide training and consultation for both internal staff and medical personnel of the Plan regarding policy application.2. Provide direction and control...