1 global compliance auditor jobs found

Thank you for considering Progyny! Progyny is seeking a Claims Audit Extern to join our team. This role will primarily support claims audits, quality assurance reviews, and other related audit activities. In this role, you’ll gain hands-on experience in healthcare claims auditing while working with provider clinics and cross-functional teams to support coding accuracy, compliance, and continuous improvement. What you'll do... Participate in claims audits and quality assurance reviews, including selecting and preparing patient claim samples, evaluating claims and provider documentation, validating CPT/HCPCS and ICD-10-CM coding, modifiers, billing accuracy, and adherence to applicable coding and documentation guidelines. Document audit findings and prepare audit reports, including workpapers, Executive Summaries/Management Response Forms, and other required audit documentation. Provide education to provider clinics and applicable stakeholders regarding audit...