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Elevance Health
Elevance Health
Sponsor pentru viza H1BAsigurare de sănătateAsistență medicalăB2B
Elevance Health este o companie de servicii medicale și asigurări de sănătate care dezvoltă o abordare mai amplă și pe termen lung pentru sprijinirea sănătății oamenilor. Activitatea sa combină beneficiile medicale, serviciile integrate pentru sănătatea întregii persoane și capacitățile de sănătate digitală, concepute pentru a conecta mai eficient îngrijirea medicală cu acoperirea de asigurare. Cu o echipă de aproape 100.000 de angajați care deservește peste 118 milioane de persoane, Elevance Health oferă roluri într-o organizație mare și multidisciplinară, concentrată pe îmbunătățirea rezultatelor în materie de sănătate, evoluția sistemului de sănătate și sprijinirea unor comunități mai puternice.
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Clinical Provider Auditor I

Review healthcare claims and medical records for potential fraud and abuse, support investigations, and recommend ways to improve coding compliance and limit losses at Elevance Health.

USStatele Unite ale AmericiiFLFloridaOHOhioTXTexasHibridNormă întreagăJuniorLimbă Obligatorie: englezăAuditor

Descriere

  • Flag claims, providers, or other entities that may present fraud or abuse risks.
  • Check claims against applicable billing and processing guidelines.
  • Identify ways to prevent and control fraud and abuse.
  • Review claims and medical records before payment.
  • Record findings in required systems and tools, then advance cases through the claims process.
  • Research emerging healthcare questions to support investigations.
  • Track changes and trends in medical coding, billing, laws, and regulations.
  • Work with the Special Investigation Unit and other internal teams.
  • Recommend loss-control and risk-reduction measures based on investigation findings.

Cerințe

  • Associate of Arts or Associate of Science degree required.
  • At least one year of related medical coding or auditing experience.
  • Equivalent combinations of education and experience may be accepted.
  • Earn a coding certification (CPC, CCS, or CPMA) within one year of starting.
  • Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology is strongly preferred.
  • Live within reasonable commuting distance of the listed work location unless a legally required accommodation applies.
  • COVID-19 and influenza vaccination may be required for certain patient- or member-facing roles.

Beneficii

  • Merit increases
  • Paid holidays
  • Paid time off
  • Incentive bonus programs
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Short-term disability coverage
  • Long-term disability coverage
  • 401(k) with employer match
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
  • Full-time virtual work except for required in-person training sessions
  • Flexible work-life integration
  • Vaccination support or coverage requirements for certain roles

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