Medical Audit Lead: Analytics-Driven Claims
Sacbar
Marsh, a global leader in risk, reinsurance and capital, seeks a Medical Audit Lead to drive end-to-end medical benefit audits. You will oversee analytics-driven claim reviews using third-party SaaS platforms, validate data, and present defensible reports to clients. This role requires 7+ years in medical claims auditing, strong plan design knowledge, and excellent communication skills. As the day-to-day audit owner, you will ensure adherence to Mercer standards, mentor auditors, and deliver #J-18808-Ljbffr Sacbar
$79k - $158.5k
Role Summary Leads end-to-end medical benefit audits, leveraging advanced analytics and third-party Software as a Service (SaaS) platform to review claims, select defensible representative samples, and... ...audit work, overseeing analytics-driven claim review activities,...MedicalClaimsMinimum wageFlexible hours- UnitedHealth Group is seeking a Health Data Analytics Consultant to advance Medicare/Medicaid... ...policy design, while supporting data-driven decision making across client... ...strong Python/SQL/R skills, experience with medical claims data, #J-18808-Ljbffr Stryker CorporationMedicalClaimsRemote jobWork at office
$160k - $180k
...providing merchants with AI-driven solutions that enhance... .... By integrating leading-edge technology with exceptional... ...our centralized Risk, Analytics & Data Science team as... ...systems — which claims initiatives to pursue,... ...experience, with full medical and dental & vision benefits...MedicalClaimsFlexible hours$600 per month
Are you driven to solve the right problems? Do you thrive... ...Experience Design Lead, you will define, lead, and implement the analytics experience across the Specialty... ...drug utilization, claims payment and denials,... ...health and well‑being. Medical, dental and vision coverage...MedicalClaimsTemporary workLocal areaFlexible hoursShift work$96k - $125k
...based care programs, we need analytical talent that can translate complex... ...storyteller: you turn dense claims and clinical data into clear,... ...in a clear, narrative-driven format. Analyze Medicare Advantage... ...by providing comprehensive medical, dental, and vision coverage....MedicalClaimsWork experience placementWork at officeRemote workFlexible hours- Founded in 1934, Medical Mutual is the oldest... ...Provides critical analytical support to the... ...creation and review; auditing ID cards, rates and... ...issues related to claims, eligibility, plan... ...on the analysis. Leads Squad Talks Calls.... ...and provides data-driven recommendations. Leads...MedicalClaimsWork at office
$91.5k - $134k
## Manager, Brand Analytics & Insights, Rare DiseaseApplylocations:... ...we tackle areas of high unmet medical need through research and innovation... ...monitoring and data-driven decision making for U.S. RDBU... ...brands* Conduct analyses using claims, prescription, specialty pharmacy...MedicalClaimsTemporary workFlexible hours- ...join our Market Access Analytics team. This position offers... ...fast-growing, science-driven organization making a... ...to complete projects. Lead & Develop Develop and... ...prescription, sales data and claims/patient level data sets... ...U.S. Buy and Bill or Medical Benefit Market Access...MedicalClaimsOngoing contractFor contractorsWorldwide
$209.6k - $313.38k
...Senior Director, Field Analytics &... ...visible leadership position leading a team responsible for... ...through objective data driven insights. The individual... ...benefits:** Comprehensive medical, dental, vision, prescription... ...processing fee, even if claimed you will be reimbursed...MedicalClaimsTemporary workLocal areaFlexible hours- ...Possibility.Position Summary:This position leads analytics, reporting, forecasting, and business... ...across underwriting, actuarial, claims, finance, operations, and product teams... ...benefits package that includes multiple medical plans plus dental, vision and prescription...MedicalClaimsFull timeTemporary work
$157.25k - $212.75k
...fast‑growing, mission‑driven company building a culture... ...data requirements and analytic models. Serve as the... ...EHR data, and coded claims data to surface... ...privacy (HIPAA), and auditability. Strategic Leadership... ...full health benefits (medical, dental, and vision),...MedicalClaimsFull timeTemporary workLocal areaRemote workFlexible hours- ...Job Title**Associate Director, Business Analytics**Requisition**JR000015868 Associate... ...research to help answer those questions* Leads a variety of primary market research and... ...pharmaceutical databases (e.g. specialty data, medical claims data, APLD) is preferred.**Knowledge***...MedicalClaimsRemote work
- ...leaders and teammates. The Lead, Data Analytics plays a critical role within... ...questions across P&C underwriting, claims, distribution, and client... ...Champion a culture of data-driven decision-making and... ...Team? The FOCUS Difference: Medical, Dental, Vision, Life, Pet;...MedicalClaimsTemporary workWork experience placementImmediate startRemote workMonday to FridayFlexible hours
- ...Investment Services, LLC is seeking a Disability Insurance (DI) Claims Analyst to evaluate eligibility, calculate benefits, and guide... ...client-centered environment focused on developing expertise in medical and financial reviews and delivering timely results across initial...MedicalClaims
- ...Possibility.Strategic Analytics is a dynamic and growing... ...build AI-first, agent-driven products that change how... ...AVP, AI Engineering to lead the design and application... ...underwriting and claims. This role is focused on... ...that includes multiple medical plans plus dental, vision...MedicalClaimsFull timeTemporary workRemote work
$130k - $180k
...dynamic reserving and loss analytics team. Reserving-related... ...studies, and claim analytics engagements.... ...auditors)Assist with and/or lead the development of new... ...responsibility as well as insight driven reserving studies.... ...that includes multiple medical plans plus dental,...MedicalClaimsFull timeTemporary workWork at office- ...Senior Internal Auditor, Risk and Analytics Paramount About Senior Internal Auditor, Risk and... ...5 years of experience in internal audit, external audit, risk management, data analytics... ...Experience executing analytics-driven operational reviews (e.g., T&E, production...Full time
$140k - $225k
Collectors is the leading creator of innovative technology... ...-on Sr HR Reporting & Analytics Manager to join our... ...regular reporting audits and monitor data quality... ...eligible to enroll in Medical, Dental, and... ...through fake e-mails claiming to be from the company...MedicalClaimsFull timeWork at officeImmediate startRemote workWorldwideFlexible hoursShift work- We are looking for a Manager, Business Analytics to lead analytics and reporting initiatives supporting... ...knowledge of healthcare data (e.g., claims, EHR, pharmacy, or related domains).... .... Insurance Benefits: We offer medical, dental, and vision benefits along with...MedicalClaimsTemporary work
- Quest Diagnostics Incorporated is seeking a driven Senior Internal Auditor to join our internal audit team. You will lead audit engagements, shape audit scope, oversee... ...roles, with a strong emphasis on AI and data analytics to uncover insights and drive efficiency. Hybrid...
$163k - $237k
...serve on Chubb's Global Analytics Risk Cohorts team,... ...in developing analytics-driven solutions that improve... ...underwriting excellence, superior claims handling expertise and... ...physical disability, medical condition, genetic... ...harassment. Experience leading business engagements and...MedicalClaimsLocal area$58k - $62k
## Claims SpecialistApplylocations: Virginia Beach,... ...Groundworks, North America's leading foundation repair and... ...- we're a team driven by purpose. As a **Top... ...Payroll, branch leadership, medical providers, Safety, and... ...service.* Strong analytical skills with the ability...MedicalClaimsWork at office- ## Medical Coding AuditorApplyremote type: Remote... ...is hiring a driven **Medical Coding Auditor... ...and supporting audit and denial... ...corrections of these claims when applicable, and... ...to the department lead as they are identified... ...solutions* Strong analytical skills, such as...MedicalClaimsWork at officeLocal areaRemote workFlexible hours
$99k - $143k
Our award-winning Cyber Claim Department has an exciting career opportunity for an individual... ...and contracts;Strong investigative and analytical skills.Strong organizational skills to... ..., mental and physical disability, medical condition, genetic information, military...MedicalClaimsLocal area$180k - $275k
The VP, Claims Transformation Domain Lead will spearhead the design and delivery of next-generation... ...and physical disability, medical condition, genetic... ...Sigma, PMP, Agile) a plusStrong analytical and critical thinking skills; data-driven decision makerInitiative-taking...MedicalClaimsLocal area$152.4k - $219.6k
...Environmental team provides specialized claim handling for Chubb insureds... ...is service-oriented, results-driven and possesses excellent... ...partners.Conduct monthly self-audits using Best Practices standards... ...mental and physical disability, medical condition, genetic information...MedicalClaimsFor contractorsLocal area$83.6k - $119.9k
The Westchester Casualty Claim Director is responsible for investigating and settling... ...in adverse or high-pressure situations. Analytical, Detailed Oriented Customer focus - responsive... ..., mental and physical disability, medical condition, genetic information, military...MedicalClaimsLocal area- ...Contracting teams. You will analyze large healthcare data, lower claims costs, and help improve quality of care while boosting member... ...databases, build reports and dashboards, and provide expert advice to Medical Directors and management on cost-of-care issues, using SQL, SAS...MedicalClaims
- Paramount is seeking a Senior Internal Auditor, Risk and Analytics to join the team in Nashville. The role focuses on analytics-driven operational reviews, internal controls, and risk management with exposure to large, complex datasets. Candidates should possess strong...
$26.44 - $52.4 per hour
...systems, hospitals and medical clinics are under... ...will be responsible for auditing of coders and coding auditors... ...initiated before the claim is rebilled to the... ...Outlook, Visio, SharePoint) Analytical skills (problem... ...schedule in a deadline driven environment Requires the...MedicalClaimsHourly payPermanent employmentWork at officeLocal areaImmediate startFlexible hoursDay shift
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