Top 33 Compliance auditor Jobs in Murfreesboro, Tn

Claims Auditor- Remote
American Health Plans —Franklin, TN
- Remote
- Mid-level
- 2 years
- Paid holidays
- Disability insurance
Quick Apply
Inventory Auditor
Costco Wholesale Corporation —Murfreesboro, TN
- Research
- Mid-level
- Driving
- AD&D insurance
- Employee stock purchase plan
Compliance Analyst
Quorum Health Corporation —Brentwood, TN
- Remote
- HIPAA
- Mid-level
- Analysis skills
- Loan repayment program
- Health insurance
Quick Apply
20h
Pre-Bill Auditor
Adoration Health —Murfreesboro, TN
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
1d
Senior Financial Internal Auditor - Hybrid
The Cigna Group —Franklin, TN
- Online Application
- Microsoft Excel
- CPA
- 3 years
Senior Manager Quality and Accreditation
Vital Care Infusion Services —Nashville, TN
- $74,481 - $93,101 a year
- Full-time
- Nursing
- 5 years
- Office
- Health savings account
- Paid holidays
Quick Apply
12d
Senior Compliance Specialist (Communications)
Fresenius Medical Care —Franklin, TN
- Full-time
- Hybrid work
- HIPAA
- Mid-level
- Bachelor's degree
11d
Information Technology (IT) Senior Internal Auditor - Hybrid
The Cigna Group —Franklin, TN
- Online Application
- Hybrid work
- Research
- Office
- 3 years
2nd Shift Sr Quality Technician
Cardinal Health —La Vergne, TN
- $22.50 - $31.00 an hour
- Mid-level
- High school diploma or GED
- No degree
- Paid parental leave
- Health savings account
7d
Coding and Medical Records Auditor
TruHealth LLC —Franklin, TN
- Mid-level
- 2 years
Quick Apply
14d
Sr. Global Quality System and Methods Manager
Franke —Smyrna, TN
- English
- Master's degree
- 8 years
Sr. Principal Quality Engineer
Cardinal Health —La Vergne, TN
- $105 an hour
- Bachelor's degree
- No degree
- Mentoring
- Paid parental leave
- Health savings account
Contract Compliance Analyst - Corp
Helix Traffic Solutions, LLC —Christiana, TN
- $25 - $27 an hour
- Full-time
- Microsoft Outlook
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
Yard Auditor
Lazer Logistics —Murfreesboro, TN
- $17.50 - $18.50 an hour
- Overtime
- Computer skills
- Communication skills
- Outdoor work
- AD&D insurance
- Paid holidays
4d
Senior IT Compliance Analyst
Ingram Content Group —La Vergne, TN
- $97,201 - $123,251 a year
- Full-time
- Computer Science
- Office
- 3 years
- Wellness program
- Health savings account
Quick Apply
Night Auditor
Lebanon Hotel —Lebanon, TN
- From $14 an hour
- Part-time
- Hotel
- Administrative experience
- Organizational skills
- Paid time off
- Employee discount
Quick Apply
Night Auditor | Homewood Suites Franklin| Franklin, Tennessee
PM Hospitality Strategies, Inc. —Franklin, TN
- Part-time
- Hotel
- Computer skills
- Associate's degree
Quick Apply
Night Auditor
Holiday Inn Epress —Antioch, TN
- $17 - $18 an hour
- Part-time
- Bilingual
- Hotel
- Administrative experience
- Employee discount
Quick Apply
Front Desk Agent / Night Auditor - avid Hotel, Smyrna TN
A S HOSPITALITY —Smyrna, TN
- $15 - $16 an hour
- Weekends as needed
- Computer literacy
- Writing skills
- Basic math
- Paid time off
- Employee discount
Quick Apply
4d
Guest Service Representative - Night Auditor-Part Time
FAIRFIELD INN & SUITES - LEBANON —Lebanon, TN
- Part-time
- Computer literacy
- English
- Mid-level
Quick Apply

I want to receive the latest job alert for compliance auditor in murfreesboro, tn

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Claims Auditor- Remote

American Health Plans -
Franklin, TN

Quick Apply

Job Details

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Referral program

Qualifications

Medicare
Managed care
Managed care organization experience
CMS
Regulatory compliance in claims processing
Medical claims processing software
CMS regulatory compliance
Health insurance knowledge
Medicare regulations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid
Quality audits
Insurance (Financial sectors)
Healthcare claims compliance audits
Audit support
Healthcare coding compliance audits

Full Job Description

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com (https://amhealthplans.com/).

If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!

Benefits and Perks include:

Affordable Medical/Dental/Vision insurance options
Generous paid time-off program and paid holidays for full time staff
TeleMedicine 24/7/365 access to doctors
Optional short- and long-term disability plans
Employee Assistance Plan (EAP)
401K retirement accounts
Employee Referral Bonus Program

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
Work assigned claim projects to completion
Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
Maintain production and quality standards as established by management
Participate in and support ad-hoc audits as needed
Other duties as assigned

JOB REQUIREMENTS:

Proficient in processing/auditing claims for Medicare and Medicaid plans
Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
Current experience with both Institutional and Professional claim payments
Knowledge of automated claims processing systems
Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.

REQUIRED QUALIFICATIONS:

Experience:
- Two (2) years’ experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
- Two (2) years’ experience in managed healthcare environment related to claims processing/audit
- Two (2) years’ experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
- Two (2) years’ experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
- Two (2) years’ experience processing/auditing claims for Medicare and Medicaid plans
License/Certification(s):
- Coding certification preferred

EQUAL OPPORTUNITY EMPLOYER

Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.

This employer participates in E-Verify.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

compliance auditor jobs in murfreesboro, tn

Claims Auditor- Remote

Inventory Auditor

Compliance Analyst

Pre-Bill Auditor

Senior Financial Internal Auditor - Hybrid

Senior Manager Quality and Accreditation

Senior Compliance Specialist (Communications)

Information Technology (IT) Senior Internal Auditor - Hybrid

2nd Shift Sr Quality Technician

Coding and Medical Records Auditor

Sr. Global Quality System and Methods Manager

Sr. Principal Quality Engineer

Contract Compliance Analyst - Corp

Yard Auditor

Senior IT Compliance Analyst

Night Auditor

Night Auditor | Homewood Suites Franklin| Franklin, Tennessee

Night Auditor

Front Desk Agent / Night Auditor - avid Hotel, Smyrna TN

Guest Service Representative - Night Auditor-Part Time

I want to receive the latest job alert for compliance auditor in murfreesboro, tn

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected