Top 25 Internal auditor Jobs in Murfreesboro, Tn

Claims Auditor- Remote
American Health Plans —Franklin, TN
- Remote
- Mid-level
- 2 years
- Paid holidays
- Disability insurance
Quick Apply
Information Technology (IT) Senior Internal Auditor - Hybrid
The Cigna Group —Franklin, TN
- Online Application
- Hybrid work
- Research
- Office
- 3 years
Senior Financial Internal Auditor - Hybrid
The Cigna Group —Franklin, TN
- Online Application
- Microsoft Excel
- CPA
- 3 years
Quality Engineer
Feintool Tennessee, Inc. —Nashville, TN
- Up to $90,000 a year
- Full-time
- Microsoft Excel
- 5 years
- In-person
- Health insurance
- Dental insurance
Quick Apply
Accounting Manager
Robert Half —Brentwood, TN
- $54 - $64 an hour
- Temporary
- Hybrid work
- CPA
- Office
- Finance
- Disability insurance
- Dental insurance
Quick Apply
7d
Controller
Advanced Correctional Healthcare —Franklin, TN
- Full-time
- CPA
- Office
- 3 years
- Disability insurance
- Health insurance
Quick Apply
IT Audit Senior Consultant
LBMC, PC —Brentwood, TN
- Full-time
- CPA
- Mid-level
- Office
Quick Apply
Sr. Global Quality System and Methods Manager
Franke —Smyrna, TN
- English
- Master's degree
- 8 years
Accounting - Controller - Full Time
MMClinic —Murfreesboro, TN
- Full-time
- Background check
- 7 years
- CPA
- Health savings account
- Disability insurance
Risk and Control Manager - IT SOX, GFRC
Amazon.com Services LLC —Nashville, TN
- $109,000 - $163,900 a year
- Full-time
- 5 years
- ERP systems
- Office
- AD&D insurance
- Health insurance
Manuf Quality Engineer
Quanta Manufacturing Nashville —La Vergne, TN
- Full-time
- Spanish
- Schematics
- Computer literacy
Quick Apply
6d
Sr IT Analyst - Security
GEODIS Logistics LLC —Brentwood, TN
- Spanish
- Azure
- 6 years
- Paid parental leave
- Dental insurance
Quick Apply
Senior Accountant - Healthcare Audit
LBMC, PC —Brentwood, TN
- Full-time
- Management
- Mid-level
- Office
- Paid time off
- Parental leave
Quick Apply
Accounting Manager - Hybrid / Remote
Surgery Partners —Nashville, TN
- Remote
- 6 years
- CPA
- Office
Quick Apply
General Accountant
SPX —Smyrna, TN
- Monday to Friday
- Mid-level
- Office
- Finance
- Health insurance
- Tuition reimbursement
Quick Apply
9d
Finance - Accountant
The City of La Vergne, La Vergne, Tennessee —La Vergne, TN
- $29.28 - $32.95 an hour
- Extended hours
- Microsoft Excel
- Mid-level
- Office
- Disability insurance
- Dental insurance
Quick Apply
12d
Member Business Lending Officer
Heritage South Community Credit Union —Shelbyville, TN
- Full-time
- Mid-level
- Office
- Business development
Manager, Accounting
Ford Ice Centers —Nashville, TN
- Overtime
- Microsoft Word
- Background check
- CPA
- Dental insurance
- Paid time off
Quick Apply
Senior Accountant Finance Integration - Hybrid
Surgery Partners —Nashville, TN
- Hybrid work
- Oracle
- Customer service
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Site Finance Manager
Mars —Franklin, TN
- Full-time
- 5 years
- Finance
- Bachelor's degree

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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

internal auditor jobs in murfreesboro, tn

Claims Auditor- Remote

Information Technology (IT) Senior Internal Auditor - Hybrid

Senior Financial Internal Auditor - Hybrid

Quality Engineer

Accounting Manager

Controller

IT Audit Senior Consultant

Sr. Global Quality System and Methods Manager

Accounting - Controller - Full Time

Risk and Control Manager - IT SOX, GFRC

Manuf Quality Engineer

Sr IT Analyst - Security

Senior Accountant - Healthcare Audit

Accounting Manager - Hybrid / Remote

General Accountant

Finance - Accountant

Member Business Lending Officer

Manager, Accounting

Senior Accountant Finance Integration - Hybrid

Site Finance Manager

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

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