Audit Jobs in Pittsburgh

Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This role will focus on..

Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Pittsburgh Pennsylvania Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns..

Job Information Humana Quality Assurance Audit Professional 2 in Pittsburgh Pennsylvania Description Humana's Marketing Operations Quality Audit team is looking for a Quality Assurance Audit Professional 2 to join working..

Job Information Humana Bilingual Quality Auditor in Pittsburgh Pennsylvania Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality...

Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Pittsburgh Pennsylvania Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience..

Job Information Humana Senior IT Compliance Professional- Controls Management (Remote / Virtual) in Pittsburgh Pennsylvania Description We are looking for a talented risk and compliance expert to help build a..

Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guideline are met. The Medical Coding Auditor work assignments are varied and frequently..

Description The Claims Quality Audit Representative 3 audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. The Claims Quality Audit Representative 3 performs advanced..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The..

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Pittsburgh Pennsylvania Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records, and reviews medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct..

Job Information Humana Senior Compliance Registered Nurse in Pittsburgh Pennsylvania Description Humana Healthy Horizons in Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory reporting for Case Management..

Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Pittsburgh Pennsylvania Description The Medical Coding Auditor reviews medical claims submitted against medical records..

Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement...

Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Pittsburgh Pennsylvania Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural..

Job Information Humana Manager, Compliance - Agent Investigation Unit in Pittsburgh Pennsylvania Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures;..

Description The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Senior Risk Management Professional work assignments involve moderately complex to complex issues where..

Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Pittsburgh Pennsylvania Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors...

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor,..