Claims Auditor
Prime Therapeutics
Prime Therapeutics is seeking a Pharmacy Claims Auditor to remotely identify waste, ensure contract compliance, and educate pharmacies on audit standards. You will analyze large datasets, select risk-based samples, and verify claims against provider manuals and state/federal regulations. The role requires a health science degree or equivalent, pharmacy technician certification, and experience in audits or QA. Remote work is available with opportunities to impact clients nationwide. #J-18808-Ljbffr
$71.1k - $97.8k
...our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost...ClaimsFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayShift work$46.99k - $122.4k
...one community at a time. Position Summary The Program Integrity Auditor is responsible for the review of records for medical,... ...including provider education, recoupment of funds or rebilling of claims, and referral to state regulators for any suspected fraud, waste...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...Description Summary: The Charge Auditor Clinical is a Registered Nurse who performs the primary functions of coordinating the process of capturing observation charges and other direct care/nursing department charges. The Charge Auditor oversees the documentation...SuggestedFull timeShift work
$331.85k
...matches dollar for dollar up to 2% of base pay.Moving Expense: $10,000 paid to moving companyMalpractice Insurance Coverage: in a claims made insurance, in an amount of $1,000,000, per claim/$3,000,000, aggregateMedical School Loan Repayment: repay up to $200,000 ($25...ClaimsContract workTraineeshipRelocation package$55k - $75k
...customer accounts and update information in the database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters to ensure timely policy issuance. Qualifications...ClaimsFor contractorsWork at office- ...of technical material. Must be capable of high-volume data entry. Assistant Business Office Manager will review, post, and submit claims that are compiled on a daily basis through the Practice Management System. This position will also be responsible for statement processing...ClaimsWork at office
- ...Scrum Master is responsible for ensuring structured, predictable, and transparent delivery of AI initiatives supporting insurance and claims operations. This role reinforces disciplined Agile practices, protects sprint commitments, and enables sustainable delivery...Claims
- ...Product Manager / Product Owner – AI is responsible for end-to-end ownership of AI initiatives for a specific Line of Business or claims domain. This role partners directly with business stakeholders to define AI-enabled improvements to claims operations, cost control...Claims
$50 - $60 per hour
...DataAnnotation is committed to creating high-quality AI. We are looking for an Auditor to join our team to help train the next generation of AI while enjoying the flexibility of remote work and the freedom to set your own schedule. This role is designed to fit a variety...Hourly payFull timeContract workPart timeWork experience placementRemote workFlexible hours$50k - $55k
...Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Representative, Auto | Property Damage PRIMARY PURPOSE OF THE ROLE: To analyze and process low to mid-level auto and transportation...ClaimsContract workWork at officeLocal areaFlexible hours$55k - $76k
...Join to apply for the Claims - Field Claims Representative role at The Cincinnati Insurance Companies in Santa Fe, NM. Make a difference with a career in insurance. At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations...Claims$57.4k - $99k
...Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum...Temporary workWork at officeImmediate startRemote work$88k - $132k
Posting Type Remote/Hybrid Job Overview About the Role The Senior Financial Systems Analyst serves as the end-to-end process subject matter expert for Zuora, owning platform administration and providing daily system support for Billing, Collections, and Revenue Accounting...Remote workHome office$22.3 - $35.2 per hour
...Receivables (AR) Team Lead assists with daily operations of the accounts receivable team, ensuring accurate and timely processing of claims, including denials and the maximation of cash flow. This role is responsible for optimizing AR processes and supporting the...ClaimsHourly payTemporary workWork at officeLocal areaImmediate startFlexible hours- ...A leading claims administration firm is looking for a Product Manager/Owner AI to own and manage AI initiatives. This role involves working closely with stakeholders to define improvements to claims operations and translating them into actionable plans. Ideal candidates...Claims
- ...complex cases and collaborating with clinical and legal teams. As an integral part of our organization, you will investigate fraud claims, prepare necessary documentation, and work directly with law enforcement. Suitable candidates must have a bachelor's degree or relevant...Claims
- ...Argo Group is seeking a temporary Workers' Compensation Claims Adjuster to adjudicate indemnity claims for various states, including New Mexico. Candidates will need 5+ years of claims experience and a Bachelor’s degree. This role offers a chance to work in a collaborative...ClaimsFull timeTemporary workRemote work
- ...CSAA Insurance Group (CSAA IG) seeks a Sr. Litigation Specialist to manage litigated auto, homeowner, and casualty claims remotely from across the United States. You will guide defense counsel, authorize settlements, and monitor costs to resolve cases effectively....ClaimsRemote workWeekday work
- Argonaut Management Services, Inc is seeking a Senior Workers' Compensation Claims Adjuster for a temporary assignment. This role will adjudicate complex claims for Arizona and has flexibility for remote work anywhere in the United States. Suitable candidates will bring...ClaimsHourly payTemporary workRemote work
$23.16 per hour
Company: Highmark Inc. Job Description: This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing...ClaimsFor contractorsWork at officeLocal area- ...What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights...Claims
- ...managementReview medical records to assist with the identification and management of denials and actively participate in the hospital's claim denial processShift & ScheduleWork Shift: 1 - DayMay require travel within the Houston Metropolitan areaRequirementsGraduate of...ClaimsShift work
$3,600 - $8,200 per week
...week) The security deposit and company deposit are fully refundable when you leave the company after 45 days. (if we don't get any claims, accidents) Let me know if you have any more questions, my phone number: (***) ***-**** Max You can do better than you do now!...ClaimsFull timeImmediate start$63.4k - $85k
A leading claims management firm is seeking a Claims Examiner for a remote role in the United States. The ideal candidate will analyze workers compensation claims to determine benefits due and ensure ongoing adjudication of claims. Responsibilities include resolving claims...ClaimsRemote job- ...Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare...ClaimsExtra income
- ...unparalleled home health care to the American Workforce including Veterans of the United States Armed Services, Workers Compensation Claims, and former energy workers (eligible for in-home care under the Department of Labor's Office of Workers' Compensation) who want to...ClaimsPart timeLive inWork at officeFlexible hours
$65k - $75k
...EEOICPA resource centers, Veteran Medical Centers, and district offices. # Assists potential EEOICPA claimants through the OWCP claims process. Serves as a resource to the Case Managers and State Administrators. # Maintains contact with professionals of various health...ClaimsFull timeLocal areaWork from homeMonday to Friday- Sedgwick is hiring a Remote Hotel Coordinator to deliver seamless hotel accommodations for insured families with compassion and precision. The role requires coordinating reservations, confirming details, and maintaining documentation, all while upholding Sedgwick's standard...Remote work
$80k - $95k
A leading global risk and claims management company is seeking a Workers Compensation Field Case Manager to support injured workers and coordinate care. This role requires RN licensure and at least 1.5 years of experience in case management. You will work in a remote environment...ClaimsRemote job- ...for every Guest Prior experience a plus About Us Chili's was born in Dallas, Texas in 1975. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand...ClaimsFull timePart timeCasual workImmediate startFlexible hoursWeekend workWeekday work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Auditor. Be the first to apply!




