Top 124 Staff auditor Jobs in Nashville Tn

Claims Auditor- Remote
American Health Plans —Franklin, TN
- Remote
- Mid-level
- 2 years
- Paid holidays
- Disability insurance
Quick Apply
Night Auditor
Hilton BNA Nashville Airport Terminal —Nashville, TN
- Full-time
- Hotel
- High school diploma or GED
- Ability to lift 50 pounds
- Health insurance
- Dental insurance
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8d
Staff Internal Auditor
Acadia Healthcare —Franklin, TN
- Full-time
- Microsoft Excel
- CPA
- English
- Health insurance
- Dental insurance
Night Auditor
Homewood Suites Nashville Downtown The Gulch —Nashville, TN
- Part-time
- Hotel
- Organizational skills
- Front desk
Quick Apply
Zero Balance Auditor
EnableComp —Franklin, TN
- Full-time
- Remote
- Microsoft Outlook
- Customer service
- Computer literacy
Quick Apply
10d
Accounting Analyst II
Keystone Automotive Industries —Antioch, TN
- Full-time
- Microsoft Outlook
- Computer literacy
- Basic math
- Paid parental leave
- Disability insurance
Coding Quality Auditor
Houston Methodist —Tennessee
- Full-time
- Anatomy knowledge
- English
- Mid-level
8d
Night Auditor
The Joseph —Nashville, TN
- Overnight shift
- Mid-level
- Hotel
- Communication skills
- Loan repayment program
- Health insurance
Night Auditor
Avid Nashville Airport Hotel —Nashville, TN
- Weekends as needed
- Hotel
- High school diploma or GED
- Organizational skills
Quick Apply
Night Auditor
Hyatt Place Nashville/Brentwood —Brentwood, TN
- Overnight shift
- Management
- Word processing
- Windows
Quick Apply
Night Auditor
SpringHill Suites Franklin Cool Springs —Franklin, TN
- Part-time
- Hotel
- High school diploma or GED
- Ability to lift 50 pounds
- Health insurance
- Dental insurance
Quick Apply
Night Auditor
Hotel Indigo —Nashville, TN
- $21 - $23 an hour
- Full-time
- Hotel
- Administrative experience
- High school diploma or GED
- 401(k) matching
Quick Apply
1d
Inventory Auditor
Costco Wholesale Corporation —Nashville, TN
- Entry level
- AD&D insurance
- Employee stock purchase plan
Legislative Auditor: TennCare
Tennessee Comptroller of the Treasury —Nashville, TN
- Full-time
- Mid-level
- Office
- Bachelor's degree
- 401(k)
- Flexible schedule
Night Auditor
Towneplace Suites Brentwood —Brentwood, TN
- Overnight shift
- Writing skills
- Basic math
- English
- Health insurance
- Dental insurance
Quick Apply
1d
Accessibility Auditor 2
QuaverEd, Inc. —Nashville, TN
- $60,000 - $70,000 a year
- Full-time
- Experience working with individuals with disabilities
- Mid-level
- Office
- Paid holidays
- 401(k)
Quick Apply
Hyatt Place Nashville Opryland Night Auditor
Hyatt Place Nashville/Opryland —Nashville, TN
- Overnight shift
- Management
- Word processing
- Windows
Quick Apply
14d
Night Auditor
North Point Hospitality —Nashville, TN
- Full-time
- Windows
- Hotel
- High school diploma or GED
- Free parking
- Health insurance
Quick Apply
Information Systems Auditor
Tennessee Comptroller of the Treasury —Nashville, TN
- Full-time
- CPA
- Computer Science
- Mid-level
- 401(k)
- Flexible schedule
Night Auditor| Comfort Inn & Suites Nashville Downtown – Stadium | Nashville, TN
PM Hospitality Strategies, Inc. —Nashville, TN
- Weekends as needed
- Hotel
- Computer skills
- Associate's degree
Quick Apply

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staff auditor jobs near nashville tn

Claims Auditor- Remote

American Health Plans -
Franklin, TN

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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.

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Refine Your Search

staff auditor jobs in nashville tn

Claims Auditor- Remote

Night Auditor

Staff Internal Auditor

Night Auditor

Zero Balance Auditor

Accounting Analyst II

Coding Quality Auditor

Night Auditor

Night Auditor

Night Auditor

Night Auditor

Night Auditor

Inventory Auditor

Legislative Auditor: TennCare

Night Auditor

Accessibility Auditor 2

Hyatt Place Nashville Opryland Night Auditor

Night Auditor

Information Systems Auditor

Night Auditor| Comfort Inn & Suites Nashville Downtown – Stadium | Nashville, TN

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