Top 17901 Program auditor i Jobs

Medical Claims Auditor I
Moda Health —Milwaukie, OR
- $18.39 - $20.58 an hour
- Weekends as needed
- Remote
- Customer service
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
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Quality Auditor - 2nd Shift
Polaris Inc. —Huntsville, AL
- $22.81 - $26.93 an hour
- Overtime
- Word processing
- Continuous improvement
- Conflict management
- Profit sharing
- Health insurance
Auditor (Claims)
SOUTHWEST SERVICE ADMINISTRATORS INC —Remote
- $19.00 - $25.50 an hour
- Remote
- Microsoft Word
- Writing skills
- Research
- AD&D insurance
- Disability insurance
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8d
Auditor/Investigator I
Qlarant —California
- $47,911 - $71,508 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Organizational skills
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14d
Auditor (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $50,904 - $101,101 a year
- Online Application
- Remote
- CPA
- Mid-level
- Finance
Quick Apply
Digital Manual Accessibility Auditor
Digital Accessibility by WeCo —Remote
- $35 an hour
- Urgently hiring
- Remote
- Mid-level
- JavaScript
- 1 year
- Work from home
- Flexible schedule
Claims Auditor
Volunteers of America, Inc. —Eden Prairie, MN
- $56,000 - $65,000 a year
- Monday to Friday
- Remote
- HIPAA
- Mid-level
- 3 years
- Wellness program
- Paid holidays
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8d
Compliance Specialist $20-$26/hr with Overtime Potential (LIHTC/Affordable Housing Exp Req; Remote)
Zeffert & Associates, Inc. —Remote
- $20 - $26 an hour
- Overtime
- Travel
- Entry level
- Health insurance
- Dental insurance
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INTERNAL AUDITOR I
The GEO Group —Boca Raton, FL
- $58,000 - $72,000 a year
- Full-time
- CPA
- Bachelor's degree
- Accounting
- Paid training
- Health savings account
Coding and Compliance Auditor
South Shore Health —Weymouth, MA
- $73,000 - $104,400 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Acute care experience
Medical Coding Auditor
IN Compass Health —Alpharetta, GA
- Full-time
- 5 years
- Acute care experience
- In-person
- Health insurance
- Dental insurance
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Production Manager - 3rd Shift
Norwich Pharmaceuticals Inc —Norwich, NY
- $85,000 - $95,000 a year
- Full-time
- Bachelor of Science
- Employment & labor law
- 3 years
- Wellness program
- Health savings account
Quick Apply
Senior Manager, Income Tax Reporting & Provision
Anheuser-Busch —St. Louis, MO
- $106,400 - $159,600 a year
- Full-time
- CPA
- Analysis skills
- GAAP
- Disability insurance
- Health insurance
Controller
The Confidential Search Company —Boston, MA
- Up to $175,000 a year
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Disability insurance
- Health insurance
Quick Apply
Quality & Food Safety Systems Manager
Izzio Artisan Bakery LLC —Louisville, CO
- $75,000 - $90,000 a year
- Weekends as needed
- 5 years
- Writing skills
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Human Resources Manager
Fibre Converters, Inc. —Constantine, MI
- $68,041.39 - $81,942.31 a year
- Full-time
- Management
- Mid-level
- Recruiting
- Health savings account
- Health insurance
Quick Apply
Auditor
Cambridge Savings Bank —Waltham, MA
- $70,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- Computer literacy
- Mid-level
- Health insurance
- 401(k) matching
Quick Apply
Quality Manager
American Paper Bag —Reno, NV
- $80,000 - $95,000 a year
- Overtime
- Background check
- 5 years
- Ability to climb stairs
- Health insurance
- Dental insurance
Quick Apply
Quality Auditor
Maysteel Industries LLC —Frederick, CO
- $21 - $25 an hour
- Full-time
- High school diploma or GED
- US work authorization
- Cleaning
- Health savings account
- Health insurance
Quick Apply
Food Safety Compliance Lead
The Hershey Company —Bluffton, IN
- Online Application
- 5 years
- Bachelor of Science
- Master's degree

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Medical Claims Auditor I

Moda Health -
Milwaukie, OR

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Job Details

Full-time
$18.39 - $20.58 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching

Qualifications

Confidential information handling
Writing skills
Medical claims processing software
High school diploma or GED
Desktop applications
Data interpretation
Typing
Productivity software
10 key typing

Full Job Description

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
Provides accurate quality assurance auditing of post-payment claims to determine correct adjudication and benefit application. Completes complex reports and provide feedback on accuracy. This is a FT WFH position.

Pay Range
$18.39 - $20.58 hourly, DOE.
**Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27778811&refresh=true

Benefits:

Medical, Dental, Vision, Pharmacy, Life, & Disability
401K- Matching
FSA
Employee Assistance Program
PTO and Company Paid Holidays

Requirements:

High school diploma or equivalent.

6 months – 2 years claim processing or customer service dealing with all types of plans/claims consistently exceeding performance levels.

Strong reading, writing, and verbal communication skills.

Good analytical, problem solving, decision making, organizational and detail-oriented skills with ability to shift priorities.

10-key proficiency on a computer numeric keypad.

Type a minimum of 25 wpm net on a numeric keyboard.

Good organizational skills, ability to work well under pressure and ability to handle a variety of functions to meet timelines.

Ability to maintain confidentiality and project a professional business image.

Ability to start work on time and daily.

Proficiency in Facets claims processing applications and Benefit Tracker.

Knowledge of the reporting tool system and Employer Online Services is helpful.

Knowledge and understanding of medical claims processing administrative policies affecting claims and customer service.

Computer proficiency in Microsoft office applications.

Primary Functions:

Audit claims daily statistically valid sampling method, using prescriber audit criteria. Performs simple adjustments as necessary.

Conduct in-depth claims audits on performance groups, as well as focus audits for specifically identified situations on a scheduled basis.

Compiles and publishes reports based on the results of claim audits as well as processor productivity on a weekly, monthly, and quarterly basis.

Run report in PBIRS to conduct audits.

Prepares required monthly and/or quarterly reports for specific group performance guarantee, production, and accuracy results.

Identify trends from audit results and recommend improvements to increase overall quality.

Assists in the investigation and response to performance group inquiries.

Other duties/tasks as assigned.

Contact with Others
Internally with Claims, Sales & Account Services, Membership Accounting, Benefit Configuration, Information Services, Customer Service and Provider Relations.

Working Conditions
Remote work environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of standard work week, including evenings and occasional weekends, to meet business need.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via our [email protected] email.

Quick Apply

Refine Your Search

program auditor i jobs

Medical Claims Auditor I

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Medical Coding Auditor

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