Quality Audit Analyst II - Medicare/Medicaid Claims
$21.1 - $49.08 per hourHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement in Albany, NY is seeking a customer-focused individual for a full-time role in Medicare and Medicaid claim processing. The ideal candidate will possess over a year's experience in high dollar claim processing and have strong analytical, problem-solving, and communication skills. This position offers a hybrid work environment and a competitive pay range of $21.10 to $49.08 per hour, along with comprehensive benefits to support employee well-being. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$24.5 - $26 per hour
Carrington is seeking a Default FHA Claims QA Analyst II to work remotely from home. In this role, you will be responsible for reviewing FHA mortgage insurance claims for accuracy, ensuring compliance with company policies and regulations. The target pay is $24.50/hr -...ClaimsRemote jobWork from home$24.5 - $26 per hour
...our amazing team and work remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for... ...accuracy within the investor/insurer timeframes. Complete quality checks using a scorecard and/or checklist to identify errors...ClaimsRemote workWork from home$21.1 - $49.08 per hour
...accountable and prioritize safety and quality in everything we do. Join us... ...for Aetna performs quality audits for service operations for... .... Government Programs Claim Quality is an exciting and... ...SOX and Sarbanes control for Medicare and Medicaid Claim Processing. We are...ClaimsHourly payFull timeWork at officeLocal areaFlexible hours3 days per week$63k - $79k
...Quality Control Analyst II in Rensselaer, NY - Nights Build your future at Curia, where our work has the power to save lives Curia is a global... ...housekeeping and preparation of the laboratory for audits Perform or assist with QC method qualifications, transfers...SuggestedContract workWork at officeShift workNight shift$63k - $79k
...Job Description Quality Control Analyst II Location: Rensselaer, NY Shift: This role is an overnight 12-hour rotating shift position . Our client is a global contract development and manufacturing organization (CDMO) with over 30 years of experience...SuggestedContract workWork at officeShift workNight shiftRotating shift- ...A healthcare solutions company is seeking a Claims Recovery Specialist in Albany, NY. This role involves managing a high-volume caseload related to Medicaid beneficiaries, ensuring compliance with HIPAA standards, and engaging with stakeholders to negotiate settlements...ClaimsWork at officeRemote work
$70.14k - $135k
NTT DATA is seeking a Senior Quality Assurance (QA) Analyst in Albany, NY. This role involves assessing and ensuring the quality of Medicaid Data Warehouse SDLC deliverables, providing constructive feedback, and contributing to QA standards. The ideal candidate will have...Remote job$71.1k - $97.8k
...auditor to review inpatient hospital claims for proper reimbursement, handle... ...for 4 years) MS-DRG coding/auditing experience Experience reading and... ...efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military...ClaimsBi-weekly payContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...Need Local Candidate and only US Citizen/GC Job Title: Quality Control Analyst II Duration: 6+ Months Qualifications Bachelor’s degree in Chemistry... ...housekeeping and preparation of the laboratory for audits Perform or assist with QC method qualifications, transfers...Local area
$75.68k - $119.2k
...Telephonic Nurse Case Manager II Location: Virtual full‑time, with required in‑person training sessions. Alternate locations may be... ...rates (as applicable). Assist with problem‑solving for providers, claims, or service issues. Assist in developing utilization/care management...ClaimsFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shift- ...across the enterprise. The analyst collaborates with a... ...CMS and DOH compliance audits. Develop and establish... ...management. Level II (in addition to Level I... ...knowledge of both the claims data sets/warehouses... ...pricing, cost containment, quality, marketing and risk...ClaimsWork at office
- NTT DATA, Inc. is looking for a Senior Business Analyst to join their team in Albany, New York. This role involves supporting contractors with CMS certification of Medicaid Enterprise Systems, ensuring they meet all compliance standards and assist in resolution of any...For contractors
$75.68k - $119.2k
...2026-07-02 Position Title: Telephonic Nurse Case Manager II Job Description: Telephonic Nurse Case Manager II Location... ..., as applicable. Assists in problem solving with providers, claims or service issues. Assists with development of utilization/...ClaimsFull timeTemporary workWork experience placementWork at officeLocal areaMonday to FridayAfternoon shift1 day per week- A recruiting firm is seeking a Quality Control Analyst II in the City of Rensselaer, NY. Candidates must have a Bachelor's degree in Chemistry or a related field and 3-5 years of experience in the pharmaceutical industry. Responsibilities include conducting analytical...
$63k - $79k
A pharmaceutical company in Rensselaer, NY is seeking a Quality Control Analyst II to perform analytical testing on raw and finished products. The ideal candidate will have a Bachelor's degree in Chemistry and 3-5 years of relevant experience in a cGMP environment. Responsibilities...Night shift$63k - $79k
Quality Control Analyst II - Rensselaer, NY - Nights Position Overview The Quality Control Analyst II is responsible for performing routine and non... ...laboratory equipment, housekeeping, and prepare lab for audits. Assist with QC method qualifications, transfers, and validations...Work at officeShift workNight shift$56k - $70k
...of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned... ...Clearbrook Group Holdings Inc.**Job Description**# **Underwriter II, Agriculture, Farm Family****We currently have TWO openings we are...ClaimsWork at officeLocal area- ...Holdings Inc. Job Description The P&C Business Analyst II is responsible for executing tasks... ..., agencies, training, compliance, claims, billing, call center, client experience... ...visionary thinker with a clear focus on quality. Must be adaptable and comfortable with...ClaimsWork at officeFlexible hours
- ...Description CUSTOMER SERVICE SPECIALIST II Seize your opportunity to make a... ...the New York State Department of Health Medicaid Management Information System (MMIS) program... ...and help the providers with their Medicaid claims. HOW A CUSTOMER SERVICE SPECIALIST...ClaimsWork at office
- ...Job Description The Actuarial Analyst performs actuarial services in... ..., risk score analysis, unpaid claim liability estimates and conducts... ...assigned by management. Level II Conducts analyses for and... ...improve data capabilities and quality of department analysis and reporting...ClaimsWork at officeRemote work
$37.87 - $59.63 per hour
...policies and procedures. Revenue Integrity Analyst II Service Areas: Emergency/Trauma, Transport,... ...alignment with charge, coding and charge edits. Audits and evaluates system automation by comparing the charge/claim data to the clinical record. Leverages other system...ClaimsHourly payWork at officeRelocationMonday to FridayFlexible hours$31.8 - $34.3 per hour
...undergraduate and/or graduate semester credit hours in accounting and/or auditing. A minimum of 2+ years of professional experience in... ...staff and providers as necessary to resolve discrepancies in claims. Identify problem areas and trends and develop solutions....ClaimsContract work- ...experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider reimbursements. This remote position... ...certifications such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and...ClaimsWork at officeRemote workFlexible hours
$29.05 - $67.97 per hour
...to ensure medical necessity and appropriate care levels. The role involves facilitating medical reviews of appeals and validating claims for coding compliance. Candidates must hold an active RN license and have at least 2 years of clinical nursing experience, particularly...ClaimsRemote jobHourly pay$48.3k - $65.9k
Humana Inc is seeking a Medical Coding Coordinator to join their team remotely from anywhere in the US. This position involves extracting clinical information from medical records and assigning procedural codes (ICD-10-CM, CPT). Candidate must have a coding certification...ClaimsRemote job$21 - $26 per hour
...duties associated with being an outsourced billing service provider including charge entry, payment posting, claims submission and follow‑up, coding and auditing Assist with cash recovery projects, including project productivity monitoring Assist with diagnostic reviews...ClaimsHourly payMonday to ThursdayNight shift- ...leading company is seeking a Senior Auditor to conduct detailed auditing and accounting services for fraud investigations involving... ...possess strong analytical skills and experience in healthcare claims, with a commitment to fostering government innovation and collaboration...Claims
- ...fiscal staff and providers as necessary to resolve discrepancies in claims; • Identify problem areas and trends and develop solutions;... ...and/or graduate semester credit hours in accounting and/or auditing; and • A minimum of two (2) years of professional experience...ClaimsContract workRemote work
$84.78k - $131.41k
...review of evidence that either supports or refutes the System's claim of compliance as it related to these areas. The Senior Internal... ...candidate will accomplish this by performing individual internal audit projects, as part of the overall Corporate Compliance and Audit...ClaimsWork at officeShift work$90k - $120k
...to demonstrate expertise in auditing and fraud services to support... ...systems, healthcare claims, reimbursement data, procurement... ...healthcare claims analysis involving Medicare, Medicaid, TRICARE, VA, and other... ..., professionalism, and quality work. Here at CGS we value...ClaimsFull timeFor contractorsInterim roleWork at officeFlexible hours
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