Senior Claims Auditor (External Audit) Astrana Health, Inc.Senior Claims Auditor (External Audit)Monterey Park, CaliforniaRemote$70,308–$80,000 / yearKnowledge of medical terminology combined with detail knowledge and experience with CPT, HCPCS, DRG, REV, OPS, ASC, ICD10, CRVS, RBRVS, CMS, ICE for Health Plan, DMHC and DHS fee schedules and CMS Medicare regulatory agencies, COB and Third-Party Liability recovery. Detail knowledge and understanding of Industry pricing methodologies, such as Resources-Based Relative Value Scale (RBRVS), Medicare/Medi-Cal fee schedule, All Patient Refined Diagnosis Related Groups (AP-DRG), Ambulatory Payment Classifications (APC), etc.
NewPT Night Auditor Crescent CareersPT Night AuditorLos Angeles, CaliforniaAt Crescent Hotels & Resorts we strive to create a great place to work where associates at all levels of our organization are respected for their differences, just like the guests and owners we serve. At Crescent Hotels & Resorts, we are a team of hospitality professionals that are deeply connected to & proud of the exceptional experiences we provide for our guests.
Night Auditor Holiday Inn & Suites AnaheimNight AuditorAnaheim, CaliforniaPart timeBalance revenue and settle accounts nightly, maintain files, and reset the system for the next day of operations while performing Guest Service Agent tasks and duties. We are also happy to arrange transportation for our guests, provided by Anaheim Resort Transit (ART) at a nominal fee, directly to Disneyland®.
Night Auditor Rebel Hotel CompanyNight AuditorRiverside, CaliforniaThe night auditor will perform reconciliations of the day's financial transitions and function as a front desk agent overnight. If you're a night owl with a passion for hospitality and numbers, join our dynamic team!
Night Auditor / Hotel Security Rebel Hotel CompanyNight Auditor / Hotel SecurityOntario, CaliforniaThe night auditor will perform reconciliations of the day's financial transitions and function as a front desk agent overnight. If you're a night owl with a passion for hospitality and numbers, join our dynamic team!
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)Costa Mesa, CA$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
DRG Coding Auditor - Ms-Drg And Apr-Drg Elevance HealthDRG Coding Auditor - Ms-Drg And Apr-DrgCosta Mesa, CA$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
NewNight Auditor Highgate Hotels LPNight AuditorOntario, CAHighgate is a leading real estate investment and hospitality management company with over $15 billion of assets under management and a global portfolio of more than 400 hotels spanning North America, Europe, the Caribbean, and Latin America. He/she is also responsible for effectively communicating concerns and/or related issues to all levels of management and performing guest service agent duties as required, including check-in, check-out, switchboard operation and reservations.
Risk Adjustment Coding Auditor Clever Care Health PlanRisk Adjustment Coding AuditorHuntington Beach, CAThe Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. The position supports enterprise risk adjustment initiatives through audit activities, RADV preparedness, chart review validation, vendor oversight, provider education, and continuous quality improvement efforts aimed at enhancing coding accuracy, documentation integrity, and risk score accuracy.
Pharmacy Part D Auditor Clever Care Health PlanPharmacy Part D AuditorHuntington Beach, CAThe Pharmacy Part D Oversight Auditor owns independent auditing and monitoring of Part D clinical compliance: CDAG (coverage determinations, exceptions, redeterminations), MTM program elements (targeting, CMR/TMR), and delegated PBM controls; ensures timeliness, accuracy, and member impact remediation are documented and audit-ready. Validate MTM targeting criteria, Comprehensive and Targeted Medication Review (CMR/TMR) completion, and annual CMS submission/attestation compliance under §423.153 and current year guidance.
Night Auditor - Full Time-2 Sonesta International Hotels CorporationNight Auditor - Full Time-2Los Angeles, California$22.50–$23 / hourAccurately process all cash and credit card transactions in accordance with established procedures including but not limited to posting all charges, completing cashier and other reports, preparing deposit, and counting/ securing assigned bank. An epic blend of full-service and focused hotels in major cities, Sonesta’s uniquely diverse portfolio of owned, managed, and franchised properties makes us everywhere you want to be.
Night Auditor General AccountsNight AuditorBuena Park, CaliforniaChecking in guests, showing that classic “customer service” smile, and always having fun with this awesome team is what we want from you. Maintain responsibility and accountability for the hotel property and the safety of guests, and have authority for the hotel operations while on duty.
Part-Time Night Auditor General AccountsPart-Time Night AuditorAnaheim, CaliforniaChecking in guests, showing that classic “customer service” smile, and always having fun with this awesome team is what we want from you. Maintain responsibility and accountability for the hotel property and the safety of guests, and have authority for the hotel operations while on duty.
Medical Auditor - Remote YO AI LabsMedical Auditor - RemoteLos Angeles, CARemoteWe are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments.
Implementation Auditor (50487) Western Growers AssociationImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
NewPT Night Auditor HEI Hotels and ResortsPT Night AuditorPasadena, CaliforniaPrepare daily Restaurant Revenue Report data by auditing Point of Service tapes/journals to breakdown revenue, covers, waiters' fees, tips paid out and settlements by type and cashier. For your financial wellness, HEI provides a wide array of coverage, including Supplemental, Spousal and Child Life insurance as well as Short and Long-Term Disability plans.
Quality Auditor Adex CorporationQuality AuditorLos Angeles, CA$35.75 / hourEnsures engineering specification, assignments, and job drawings are in accordance with specifications and that proper documentation is provided. • Ability to fly or operate a motor vehicle, possess valid US Driver's License, and maintain an approved Motor Vehicle Record.
Auditor 1 Inland Regional CenterAuditor 1San Bernardino, CaliforniaReview vendor payroll records to determine if there are sufficient direct care staff at the vendor’s facility/program to provide the prescribed level of consumer care in accordance with DDS guidelines for the assessed level of care of the consumers, the vendor’s program design, and the Welfare and Institutions Code. Prepare reports for management on audit findings to include an opinion on the accuracy, reasonableness and adequacy of the vendor’s financial statements; suggestions for cost savings, if any; suggested improvements in the vendor’s internal controls and/or record keeping; related party transactions; and compliance with State regulations.
Warehouse Auditor - PM Shift Coastal Pacific Food DistributorsWarehouse Auditor - PM ShiftOntario, CAPosition Summary: On outbound shipments, break down pallets of product to check for accuracy in quantities, to ensure correct product was selected and that no damage product is being shipped, therefore eliminating RODS and VCMS. Knowledge: Proficient in Microsoft applications Working knowledge and understanding of Warehouse Management System (WMS) ability to learn.
Night Auditor Residence Inn San BernardinoNight AuditorSan Bernardino, CaliforniaWe operate over 75 hotels in 20+ states for some of the Nation’s largest REIT’s and private real estate owners, in addition to a large portfolio of individual and family-owned hotels. As a Night Auditor, you will work overnight (graveyard) hours to supervise the hotel and perform tasks to certify that all daily transactions are reconciled.