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Cincinnati Children's Hospital Medical Center Logo
Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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Duke University Health System

Durham, North Carolina

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Duke University Health System

Raleigh, North Carolina

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WMC Health

Suffern, New York

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Nicklaus Children’s Health System

Miami, Florida

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WakeMed Health & Hospitals

Raleigh, North Carolina

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Penn State Health

Hershey, Pennsylvania

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The Queen's Health Systems

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Atlantic Health (SP)

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Duke University Health System

Durham, North Carolina

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AdventHealth

Ocala, Florida

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Vanderbilt Health

Nashville, Tennessee

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WakeMed Health & Hospitals

Raleigh, North Carolina

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Akron Children's Hospital

Akron, Ohio

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WakeMed Health & Hospitals

Raleigh, North Carolina

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UNM Hospital

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WakeMed Health & Hospitals

Raleigh, North Carolina

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ChristianaCare Health System

Wilmington, Delaware

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Akron Children's Hospital

Akron, Ohio

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WakeMed Health & Hospitals

Raleigh, North Carolina

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CHRISTUS Health

San Antonio, Texas

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UNM Hospital

Albuquerque, New Mexico

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WakeMed Health & Hospitals

Raleigh, North Carolina

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Claim Auditor I
Summary The Claim Auditor is responsible for ensuring that their assigned sampling of adjudicated claims for Texas Medicaid and CHIP programs are audited on a monthly basis. The Claim Auditor is responsible for routine and moderately complex audits on paper and electronic claims for payment integrity in alignment with regulatory standards, timelines, business policy, provider and HHSC contracts, appropriate coding and system configuration. Audits may include physician, outpatient, inpatient, facility, and long term services and support claims. Results of the audits are to be communicated to the Claims Department. Production and operational reports must be provided to the Director of Complia


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