Remote Claims Audit & Compliance Lead

Providence; Mission Hills (CA); Remote; USD 80.003.000 - 89.544.000; Vollzeit

Zusammenfassung

Providence is seeking a claims internal audit leader to oversee audit processes for adjudicated claims and encounters, monitor check runs, and develop policies for periodic audits. The role includes training providers and staff on compliance with state and federal regulations, AB1455, and provider dispute tracking.

You will liaise with health plans, patients, hospitals, and IT to ensure high-quality, responsive service.

Jobbeschreibung

Providence is seeking a claims internal audit leader to oversee audit processes for adjudicated claims and encounters, monitor check runs, and develop policies for periodic audits. The role includes training providers and staff on compliance with state and federal regulations, AB1455, and provider dispute tracking.

You will liaise with health plans, patients, hospitals, and IT to ensure high-quality, responsive service.