Remote High-Dollar Claims Auditor
Brighton Health Plan Solutions
- Remote job
Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for accurate billing, pricing and adjudication. This remote role involves interacting with many internal and external stakeholders to help ensure quality and compliance in the claims process. You will review pricing, pricing implants and supply charges, DRG accuracy, and related charges; develop reporting to track high dollar claims; and collaborate with the CMO, Legal and external vendors as needed. #J-18808-Ljbffr Brighton Health Plan Solutions
- Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high-dollar claims for accurate billing, pricing, and adjudication. This role supports the Quality Department and interfaces with multiple stakeholders. The ideal candidate has significant facility...Claims
- ...seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and DRG codes, and... ...improve payment accuracy while supporting cost reduction. Remote work with occasional travel to Humana offices; hours...Remote workClaims
- ...Claims AuditorCentivo is seeking a Claims Auditor who will be responsible for conducting pre-payment, post-payment,... ...product lines, including complex, high-dollar claims. This role plays a key part... ...will be considered for remote positions.Centivo Values:Resilient...Remote workClaimsWork at officeImmediate start
$400 per month
...Vehicle Inventory Rep & Auditor CCC Intelligent Solutions Inc. (... ...platform for the multi-trillion-dollar insurance economy, creating... ...that simplify and enhance the claims and repair journey. Through purposeful... ...various weather conditions High school diploma or equivalent...Remote workClaimsHourly payExtra incomeCasual workImmediate startFlexible hoursWeekday work- ...Role Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for appropriate and accurate billing, pricing and adjudication... ...internal and external stakeholders. * This is a remote role. Primary Responsibilities Review high...Remote workClaimsFull timeFlexible hours
- Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for accuracy in billing, pricing and adjudication. The role supports the Quality Department and collaborates with internal and external stakeholders to ensure proper reimbursement...Claims
- Imagine360 is seeking a Stop Loss Claims Auditor to join the team! This... ...procedures. Position Location: 100% remote Responsibilities... ...disclosed claimants or extremely high‑risk claimants after review of... ...-5 years of processing first dollar medical claims Processing Stop...Remote workClaimsTemporary workWork at office
- ...HealthPosted: 2026-08-19Elevance Health is seeking a DRG Coding Auditor to ensure accuracy in MS-DRG and APR-DRG classifications... ...review with coding expertise to audit and generate high-quality recoverable claims for the company and its clients.The position offers hybrid...Remote workClaims
- ...Elevance Health is seeking a DRG Coding Auditor to review inpatient records and... ...and document audit findings. Hybrid/remote work with occasional in-person training... ...supports this role.The position emphasizes high-quality recoverable claims across lines of business, using audit...Remote workClaims
$78.91k - $98.64k
...of hospital inpatient claims and related inputs. Determines... ...coordinator and/or auditor. # Certified... ...processes to review large dollar hospital claims. Enhances... ...screens. A reliable, high-speed, hard-wired internet... ...required to support remote or hybrid work. Must be...Remote workClaimsHourly payFull timeWork at officeWork from homeAfternoon shift- ...an experienced Medical Coding Auditor to support our continued growth... ...other third-party payers is highly valued, as is familiarity with... ...Understanding of billing platforms and claim workflows-how coding feeds... ...and occasionally exerting up to 10 pounds of force. #LI-RemoteRemote workClaims
- ...Management is looking for a detail-oriented Claims Auditor to join our team in Sherman Oaks, CA. In... ...Angeles area, dedicated to delivering high-quality, coordinated healthcare to... ...making a meaningful impact in the healthcare industry. This is a remote position....Remote workClaimsWork at office
$50k - $55k
...Medical Claims Auditor (Remote - Texas) Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell... ...reimbursement information. Demonstrated ability to perform high-volume outreach and communication, including 30+ daily...Remote workClaimsMonday to Friday- ...verify provider information and documentation for claim audits, including itemized bills and medical records. This is a remote position. Responsibilities include... ..., and protecting the privacy of PHI and PII. A high school diploma and office experience are required...Remote jobClaims
- ...Senior Auditor Employment Type: Full Time, Mid-level CGS is seeking a Senior Auditor... ...district legal staff by conducting medical claims data analysis, forensic investigations,... ...voluminous and complex. CGS brings motivated, highly skilled, and creative people together to...Remote workClaimsFull timeFlexible hours
- Insight Global is seeking a DRG Validation Auditor to sit 100% remote. You will audit inpatient records, ensure DRG accuracy, and generate high-quality recoverable claims, drawing on MS-DRG/AP-DRG/APR-DRG knowledge. 5-7+ years in ICD-9/10CM and related coding, with RN coding...Remote jobClaims
- ...seeking a talented individual for a remote Outpatient Coding Auditor (Professional and Facility), the consultant... ..., and modifier codes. • Review claims to validate submitted codes and... ...Connectivity: Must maintain a reliable, high-speed internet connection at minimum...Remote workClaimsContract workWork at officeShift work
$46.99k - $122.4k
...Program Integrity Auditor We're building a world of health around every individual — shaping... ..., recoupment of funds or rebilling of claims, and referral to state regulators for any... ...(2+ years of relevant experience + high school diploma or GED). Anticipated...Remote workClaimsHourly payFull timeMonday to FridayFlexible hours- ...Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment Centers is an equal opportunity... ...Medical Coding Auditor Conducting audits of claims and patient records to identify... ...Certified Professional Medical Auditor (CPMA) High School diploma, GED or equivalent....Remote workClaimsTemporary workMonday to FridayShift work
- The Elevance Health Company seeks a DRG Coding Auditor to audit inpatient medical records and generate high-quality recoverable claims for all lines of business. You will apply advanced ICD-10 coding principles and DRG logic to substantiate conclusions and ensure accurate...Remote jobClaims
- ...Coding AuditorApplyremote type: Remote USlocations: Remote - USAtime type... ...hiring a driven **Medical Coding Auditor** to join our positive, passionate, and high-performing BOOST Services team focused... ...needed corrections of these claims when applicable, and performs quality...Remote workClaimsWork at officeLocal areaFlexible hours
- ...Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business,... ...medical record reviews, supporting high-quality recoveries and audit... ...teams. The role offers hybrid/remote work with required in-person training...Remote jobClaims
- ...is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy, and regulatory...Remote jobClaimsWork from home
- ...Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an... ...and/or inpatient coding and has a high level of understanding of reimbursement... ...generating high-quality recoverable claims for the benefit of our client and...Remote workClaims
- ...FL (On-site preferred; Hybrid/Remote may be considered) Employment... ...Senior Medical Coding Auditor (CPC) to join our growing multi... ...clinical documentation before claims are submitted to ensure accurate... ...detail-oriented, proactive, and highly experienced in physician coding...Remote workClaimsHourly payPart timeWork at officeWork from homeMonday to FridayFlexible hours
$38.46 - $52.4 per hour
...future. The Inpatient Coding Auditor will be responsible for the... ...action is initiated before the claim is rebilled to the insurance.... ...decrease denials. Maintains a high degree of professional and... ...standards #LI-CM1 #LI-Remote The estimated pay range for...Remote workClaimsHourly payPermanent employmentWork at officeLocal areaImmediate startFlexible hoursDay shift- ...the model of care. The Coding and Medical Records Auditor will be responsible for conducting coding audits prior to claims submission. This position will ensure... ...assigned coding projects to completion. Provide a high level of customer service to internal and external...Remote jobClaims
- ...will I be doing in this role? The Coding Auditor works under the general direction of the... ...Supervisor. Qualifications Requirements High school diploma or GED required. Degree in... ...upon hire. Facility outpatient surgical claims experience highly preferred. Why work here...Remote jobClaimsLocal area
$100k - $102.5k
...Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy,... ...clearly and concisely, maintaining a high standard of accuracy and quality... ...to regulatory changes Remote Work Requirements High speed internet...Remote workClaims- ...Job Title Healthcare Compliance Auditor Job Description This position reports to... ...used for coding and billing for medical claims. Knowledge of medical terminology, disease... .... Qualifications Education: High School Diploma or equivalent (higher degree...Remote jobClaimsWork experience placementWork at office
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