4 jobs found in Flowood

Senior Clinical Compliance Auditor At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers. The Senior Clinical Compliance Auditor collaborates with data...

A prominent health insurance provider in Flowood, MS is seeking a Compliance Auditor responsible for auditing Network Providers to ensure compliance and address issues related to fraud, waste, and abuse. The ideal candidate will have a Bachelor's Degree in a relevant field and at least three years of audit experience. This full-time position offers a supportive work environment and a comprehensive benefits package. #J-18808-Ljbffr

Senior Clinical Compliance Auditor page is loaded## Senior Clinical Compliance Auditorlocations: Flowood, MStime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100294# Healthy Careers Start HereAt Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle.# Job Summary:The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant...

A leading health insurance provider in Mississippi is seeking a Senior Clinical Compliance Auditor. This role involves reviewing clinical data, coordinating and validating billing practices for healthcare providers, and working closely with various teams. Required qualifications include a Bachelor's degree in Nursing and at least three years of relevant experience. The ideal candidate will possess strong communication, organizational, and analytical skills. Join us to promote health and wellness throughout Mississippi. #J-18808-Ljbffr