RoanokeRecruiter Since 2001
the smart solution for Roanoke jobs

Clinical Provider Auditor I (Remote)

Company: Anthem, Inc
Location: Roanoke
Posted on: March 28, 2020

Job Description:

Clinical Provider Auditor I (Remote) (PS34763)Location: United StatesNewRequisition #: PS34763Post Date: 13 hours agoYour Talent. Our Vision. At Anthem, Inc ., its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Clinical Provider Auditor IThis role is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse.Primary duties may include, but are not limited to:

  • 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.
  • Requires an Associate degree or equivalent combination of education and experience.
  • Must also achieve coding certification (CPC, CCS, CPMA) within 6 months of starting in this position and have knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology.
  • 1- 3 years related medical coding/auditing experience, no prior fraud/waste abuse experience necessary.Anthem, Inc. is ranked as one of Americas Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

Keywords: Anthem, Inc, Roanoke , Clinical Provider Auditor I (Remote), Accounting, Auditing , Roanoke, Virginia

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Accounting, Auditing Jobs


Financial Analyst *NEW*
Description: Banyan Search is assisting a wonderful client that is adding to their financial planning/analysis team due to growth. The Financial Analyst will be an integral team member that will be challenged to: (more...)
Company: Banyan Search
Location: Greensboro
Posted on: 04/1/2020

Financial Controller
Description: Financial Controller in Greensboro, NC at VoltDate Posted: 3/23/2020Job Snapshot ul li Employee Type: Contingent li Location: Greensboro, NC li Job Type: Accounting li Duration: 48 weeks li (more...)
Company: Volt Workforce Solutions
Location: Greensboro
Posted on: 03/28/2020

Senior Accountant
Description: A CRG client in the Triad area is looking for a Senior Accountant to join their growing team This client offers a full benefits package 100 paid health insurance
Company: CRG
Location: High Point
Posted on: 04/2/2020


Senior Product Manager, Market Data
Description: S P Global is seeking a Senior Product Manager to support our Market Data solutions for the S P Market Intelligence platform. Our ideal candidate will have: Strong product thinking skills and user experience (more...)
Company: SP Global Market Intelligence
Location: Charlottesville
Posted on: 03/28/2020

Assistant Controller
Description: Summary of Role:Our client is a 100 year successful corporation that manufactures specialty engineered products for several markets including original equipment manufacturers and tier-one suppliers. (more...)
Company: Vida Group International
Location: Greensboro
Posted on: 04/1/2020

Staff Accountant
Description: A Staff Accountant job in Greensboro, NC is available with Graham Personnel Services. This is a Direct Hire job opportunity. -- The Staff Accountant computes and prepares data for journal entries and (more...)
Company: Graham Personnel Services
Location: Greensboro
Posted on: 04/1/2020

2020 Summer Financial Analyst Program --- Commercial Banking
Description: At Wells Fargo, we want to satisfy our customers--- financial needs and help them succeed financially. We---re looking for talented people who will put our customers at the center of everything we do. (more...)
Company: Wells Fargo
Location: Winston Salem
Posted on: 04/1/2020

RCM Specialist- Cash Processing
Description: Job Summary Welcome to a promising future with this unique career opportunity. At Carilion Clinic, our team provides support for Revenue Cycle Management in a forward-thinking environment. You will thrive (more...)
Company: Carilion Clinic
Location: Roanoke
Posted on: 03/28/2020

Loan Servicing Specialist 3
Description: Job DescriptionImportant Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume when submitting your application for (more...)
Company: Wells Fargo Bank
Location: Winston Salem
Posted on: 04/2/2020

Senior Financial Analyst
Description: Senior Financial Analyst -- Our client, an international leader in their industry, has an immediate need for a Sr. Financial Analyst.-- Will be responsible for supporting the Director of Financial Planning (more...)
Company: Advanced Personnel Resources, Inc.
Location: Greensboro
Posted on: 04/2/2020

Log In or Create An Account

Get the latest Virginia jobs by following @recnetVA on Twitter!

Roanoke RSS job feeds