Elevance Health
Grand Prairie, TX, USA
Location: Grande Prairie, TX Or Houston, TX
Hours: Monday - Friday
Travel: Field Based- Travel to provider locations as needed
Position Overview:
A Provider Auditor’s responsibility will include overseeing compliance audit processes and ensuring adherence to regulatory requirements across the organization. A Provider Auditor will support business objectives by managing audit plans and conducting thorough evaluations of internal controls. Key tasks involve developing audit strategies, facilitating approvals, implementing audit procedures, and ensuring compliance with industry standards and regulations, all while managing audit-related budgets and achieving set objectives.
How You Will Make an Impact:
Selects providers to be reviewed based on historical results of other reviews with providers, network management input and dollar volume of provider
Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using...
Job Specialty: |
Audit
|