Top 26 Loss control consultant Jobs in Annapolis Md

Clinical Provider Auditor II - Maryland Behavioral Health
Elevance Health —Hanover, MD
- $61,320 - $76,650 a year
- Full-time
- Research
- Mid-level
- Office
- Employee stock purchase plan
- Paid holidays
12d
Loss Prevention Associate
Shoppers World LTD Inc —Baltimore, MD
- Weekends as needed
- Data analysis skills
- High school diploma or GED
- Team management
Claim Recovery Agent (Subrogation Adjuster)
Phoenix Loss Control —Baltimore, MD
- From $100,000 a year
- Choose your own hours
- Computer literacy
- Writing skills
- Mid-level
- Flexible schedule
Quick Apply
Premium Auditor
ARMStrong Insurance Services —Baltimore, MD
- $44 - $50 an hour
- Full-time
- Remote
- Microsoft Word
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Global Casualty Claims Specialist
Under Armour —Baltimore, MD
- $60,000 - $80,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Customer service
- Research
- Store discount
- Health insurance
Operations Manager
Boise Cascade Company —Baltimore, MD
- $64,700 - $125,700 a year
- 7 years
- Mid-level
- Office
- Paid parental leave
- Health insurance
Quick Apply
Regional Manager
Richman Property Services —Bladensburg, MD
- $125,000 - $130,000 a year
- Full-time
- 3 years
- Analysis skills
- Bachelor's degree
- Loan repayment program
- Disability insurance
Quick Apply
Operations Supervisor Hauling
Republic Services —Baltimore, MD
- $78,900 - $108,450 a year
- Full-time
- Mid-level
- Supervising experience
- Accounting
- AD&D insurance
- Employee stock purchase plan
Commercial Insurance Inspector- (Glen Burnie, MD.)
EXL Services —Glen Burnie, MD
- Part-time
- Construction site
- Computer literacy
- Mid-level
Commercial Insurance Inspector- (Bowie, MD.)
EXL Services —Bowie, MD
- Part-time
- Construction site
- Computer literacy
- Mid-level
Safety Manager, Construction
The Poole and Kent Corporation —Baltimore, MD
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
Supply & Distribution Manager (Logisitcs)
Woodland Job Corps —Laurel, MD
- $50,000 a year
- Full-time
- Computer literacy
- Writing skills
- High school diploma or GED
Quick Apply
Checker (USA)
C. Steinweg Group —Baltimore, MD
- Overtime
- Customer service
- Pass drug screening
- Maintenance
Shipping & Receiving Clerk (USA)
C. Steinweg Group —Baltimore, MD
- Overtime
- Customer service
- Computer literacy
- Basic math
Branch Operations Lead - Downtown Baltimore Branch - Baltimore, Maryland
JPMorganChase —Baltimore, MD
- $25.87 - $31.73 an hour
- Weekends as needed
- Management
- Mid-level
- Office
- Health insurance
- Tuition reimbursement
9d
Forklift Operator (USA)
C. Steinweg Group —Baltimore, MD
- Overtime
- Pass drug screening
- Forklift
- Math
MASTER PROFILE Center Director
Sylvan Learning - Corporate —Baltimore, MD
- Weekends as needed
- Writing skills
- Mid-level
- Analysis skills
Quick Apply
Application Security Engineer
H.W. Kaufman Group —United States
- Full-time
- Remote
- 5 years
- Salesforce
- Analysis skills
Refinery Safety & Health Manager
ResponsAble Staffing —United States
- From $130,000 a year
- Evenings as needed
- 5 years
- Computer literacy
- Bachelor of Science
- Relocation assistance
- Health insurance
Quick Apply

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Clinical Provider Auditor II - Maryland Behavioral Health

Elevance Health -
Hanover, MD

Apply Now

Job Details

Full-time
$61,320 - $76,650 a year
12 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Healthcare financial misconduct investigations
Research
Retrospective medical coding audits
Insurance claims auditing
Healthcare claims compliance audits

Full Job Description

Clinical Provider Auditor II

Supports Payment Integrity & Behavioral Health

Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center-connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together.

Among us are specialty-care physicians, nurse practitioners, pharmacists, engineers, data scientists, and other dedicated and caring health professionals. While our roles may differ, our purpose is shared: to make a positive impact on whole health.

A proud member of the Elevance Health family of companies, Carelon Behavioral Health uses our powerful combination of experience, expertise, dedication and compassion to see what's possible and what's better. Born out of one of the largest healthcare systems organization in the United States, our rich history gives us a unique and valuable perspective on how to solve the most pressing healthcare challenges.

Location: The ideal candidate must reside within the state of Maryland.

Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Clinical Provider Auditor II will be responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse.

How you will make an impact:

Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control.
Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations and continue to next step in the claims lifecycle.
Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations.
Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.
Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
Assists with training of new associates.

Minimum Requirements:

Requires a AA/AS and minimum of 3 years medical coding/auditing experience, including minimum of 1 year in fraud, waste abuse experience; or any combination of education and experience, which would provide an equivalent background.
Requires coding certification (CPC, CCS, CPMA).

Preferred Skills, Capabilities and Experiences:

Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology and Bachelors degree strongly preferred.
Behavioral Health coding and auditing experience preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $61,320.00 - $76,650.00.

Location: Maryland.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

loss control consultant jobs in annapolis md

Clinical Provider Auditor II - Maryland Behavioral Health

Loss Prevention Associate

Claim Recovery Agent (Subrogation Adjuster)

Premium Auditor

Global Casualty Claims Specialist

Operations Manager

Regional Manager

Operations Supervisor Hauling

Commercial Insurance Inspector- (Glen Burnie, MD.)

Commercial Insurance Inspector- (Bowie, MD.)

Safety Manager, Construction

Supply & Distribution Manager (Logisitcs)

Checker (USA)

Shipping & Receiving Clerk (USA)

Branch Operations Lead - Downtown Baltimore Branch - Baltimore, Maryland

Forklift Operator (USA)

MASTER PROFILE Center Director

Application Security Engineer

Refinery Safety & Health Manager

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