Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Claims Auditor in Santa Fe, NM vacancy
  • $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... 
    Claims
    Full time
    Contract work
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office
    Monday to Friday
    Shift work

    Humana

    Santa Fe, NM
    2 days ago
  • $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... 
    Claims
    Hourly pay
    Full time
    Temporary work
    Local area
    Monday to Friday
    Flexible hours

    NACBA

    Santa Fe, NM
    4 days ago
  •  ...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... 
    Suggested
    Full time
    Shift work

    Christus Health

    Santa Fe, NM
    21 hours ago
  • $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... 
    Claims
    Contract work
    Traineeship
    Relocation package

    Southern Ohio Medical Center

    Santa Fe, NM
    3 days ago
  • $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... 
    Claims
    For contractors
    Work at office

    Garrett Seawright - State Farm Agent

    Santa Fe, NM
    21 hours ago
  •  ...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... 
    Claims
    Work at office

    SANTA FE HOSPITAL

    Santa Fe, NM
    2 days ago
  •  ...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

    Sedgwick

    Santa Fe, NM
    2 days ago
  •  ...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

    Sedgwick

    Santa Fe, NM
    21 hours ago
  • $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 pay
    Full time
    Contract work
    Part time
    Work experience placement
    Remote work
    Flexible hours

    DataAnnotation

    Santa Fe, NM
    1 day ago
  • $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... 
    Claims
    Contract work
    Work at office
    Local area
    Flexible hours

    Sedgwick

    Santa Fe, NM
    3 days ago
  • $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

    The Cincinnati Insurance Companies

    Santa Fe, NM
    1 day ago
  • $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 work
    Work at office
    Immediate start
    Remote work

    Ensemble Health Partners

    Santa Fe, NM
    4 days ago
  • $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 work
    Home office

    Relativity

    Santa Fe, NM
    3 days ago
  • $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... 
    Claims
    Hourly pay
    Temporary work
    Work at office
    Local area
    Immediate start
    Flexible hours

    Cardinal Health

    Santa Fe, NM
    3 days ago
  •  ...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

    Sedgwick

    Santa Fe, NM
    22 hours ago
  •  ...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

    Hispanic Alliance for Career Enhancement

    Santa Fe, NM
    3 days ago
  •  ...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... 
    Claims
    Full time
    Temporary work
    Remote work

    Argo Group

    Santa Fe, NM
    1 day ago
  •  ...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.... 
    Claims
    Remote work
    Weekday work

    CSAA

    Santa Fe, NM
    2 days ago
  • 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... 
    Claims
    Hourly pay
    Temporary work
    Remote work

    Argonaut Management Services, Inc

    Santa Fe, NM
    21 hours ago
  • $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... 
    Claims
    For contractors
    Work at office
    Local area

    Highmark Health

    Santa Fe, NM
    3 days ago
  •  ...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

    Dreambound Inc.

    Santa Fe, NM
    21 hours ago
  •  ...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... 
    Claims
    Shift work

    Houston Methodist

    Santa Fe, NM
    2 days ago
  • $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!... 
    Claims
    Full time
    Immediate start

    K1 TRANSFREIGHT INC

    Santa Fe, NM
    21 hours ago
  • $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... 
    Claims
    Remote job

    Sedgwick

    Santa Fe, NM
    4 days ago
  •  ...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... 
    Claims
    Extra income

    Dane Street

    Santa Fe, NM
    3 days ago
  •  ...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... 
    Claims
    Part time
    Live in
    Work at office
    Flexible hours

    CNS Cares

    Santa Fe, NM
    21 hours ago
  • $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... 
    Claims
    Full time
    Local area
    Work from home
    Monday to Friday

    Critical Nurse Staffing

    Santa Fe, NM
    21 hours ago
  • 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

    Sedgwick

    Santa Fe, NM
    3 days ago
  • $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... 
    Claims
    Remote job

    Sedgwick

    Santa Fe, NM
    1 day ago
  •  ...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... 
    Claims
    Full time
    Part time
    Casual work
    Immediate start
    Flexible hours
    Weekend work
    Weekday work

    Chili's Grill & Bar

    Santa Fe, NM
    21 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Claims Auditor. Be the first to apply!