Quality Audit Analyst II - Medicare/Medicaid Claims
$21.1 - $49.08 per hourHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is seeking a full-time candidate for the role focusing on Medicare and Medicaid High Dollar claims. The ideal applicant will possess strong analytical and organizational skills, and be comfortable with quality goals. With the role supporting a hybrid work environment, applicants should be prepared to work onsite three days a week. A comprehensive benefits package is included, along with competitive pay rates ranging from $21.10 to $49.08. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$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- Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with...ClaimsWork experience placement
$70k - $85k
...Adjustment Coding Specialist II - Maryland Department: Quality - Risk Adjustment... ...to verify that all Medicare Advantage,... ...monitor, and document claims and encounter coding... ...and/or coding quality audits of medical records to... ...changes in Medicare, Medicaid, and private payer...ClaimsFull timeWork at officeRemote work$59.3k - $80.9k
...Medical Coding Auditor reviews medical claims submitted against medical records... ...: Experience with coding/auditing multispecialty surgical procedures... ...efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military...ClaimsFull timeTemporary workApprenticeshipRemote workWork from home$59.9k - $98.2k
Zurich NA in Annapolis, MD, seeks a Workers Compensation Claims Specialist II to manage claims with moderate to high complexity. Responsibilities include assessing claims, determining liability, and negotiating settlements to ensure efficient service. Qualified candidates...Claims$48.3k - $65.9k
...Coordinator responsible for reviewing disputes on adjudicated claims and performing coding duties remotely. Candidates should... ...at least 3 years of coding experience and be well-versed in Medicare and Medicaid guidelines. This position offers a competitive salary range...ClaimsRemote job$19.92 - $29.87 per hour
...timely submission of all claims and timely follow up.... ...billing requirements for Medicare, Blue Cross, Medical... ...simultaneously while maintaining quality and accuracy**... ...mail, and in person.* Audits primary patient bills for... ...under Medicare, Medicaid, most private insurance...ClaimsWork at officeLocal area- Healthcare Quality Data Analyst job at SGS Consulting. Maryland. Job Responsibilities: At least 2 years’ experience with Managed Care or other health care related entities Claims data experience Expert in Excel including Macros/VBA and Power Query Proficient/formal training...Claims
$50 - $60 per hour
A leading AI development company is looking for a Claims Adjuster to improve AI Assistant responses related to finance. This role allows for full-time or part-time work, with the freedom to choose projects and set your schedule. Candidates should have expert financial...ClaimsRemote jobHourly payFull timeContract workPart timeFlexible hours- ...Provide ad‑hoc reporting and claims analysis to support... ...solutions. Mentor and train new analysts, supporting their professional... ...ad‑hoc provider and claims audits to ensure accurate system... ...required. Experience with Medicare Advantage, Medicaid, commercial health plans, and...ClaimsWork experience placement
$70k - $85k
...Overview Department: Quality - Risk Adjustment Employment... ...to verify that all Medicare Advantage, Affordable Care... ...monitor, and document claims and encounter coding... ...and/or coding quality audits of medical records to ensure... ...changes in Medicare, Medicaid, and private payer requirements...ClaimsFull timeWork at officeWork from homeMonday to Friday$46.99k - $122.4k
...accountable and prioritize safety and quality in everything we do. Join us... ...include reviews and audits of provider records to ensure... ...recoupment of funds or rebilling of claims, and referral to state... ...currently administers benefits to Medicaid members across multiple lines...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$59.3k - $80.9k
A leading U.S. healthcare company is seeking a Medical Coding Auditor to review medical claims and ensure compliance with coding guidelines. This role involves analyzing medical documentation, confirming CPT coding assignments, and maintaining strict confidentiality. Ideal...ClaimsRemote job- Qlarant in Maryland is seeking a skilled auditor to ensure the integrity of claims processes. This role involves conducting detailed audits and investigations into customer claims, providing recommendations for resolution, and preventing fraudulent activities. The ideal...Claims
$25 - $29 per hour
...support timely revenue collection for assigned groups. You will handle coding, entry of patient information, and track high dollar claims through resolution. This remote role requires candidates to be located in specific operating states. The ideal applicant must possess...ClaimsRemote jobHourly pay$59.9k - $98.2k
Workers Compensation Claims Specialist II 133801 Zurich is seeking an experienced Workman’s Compensation Claims Specialist to join our team!... ...available tools and resources within authority limits. Meet quality standards by following best practices. Ensure customer...ClaimsFull timeTemporary workFor contractorsApprenticeshipWork at officeLocal areaRemote workVisa sponsorship- ...Renewal rate and funding projections and modeling Analysis of claims utilization Rate and contribution analysis Benchmarking... ...reviewed party. May also act as a reviewer for Associate Analyst I and Associate Analyst II work. Receive assistance and guidance from Benefit...ClaimsTemporary workWork at officeLocal areaFlexible hours
- J29, Inc is seeking a part-time Physician Auditor to perform blinded Independent Review clinical evaluations while adhering to Medicare guidelines. The position is contingent upon the successful award of the associated contract. The ideal candidate has over 10 years of...ClaimsRemote jobContract workPart timeFlexible hours
$108.5k - $155k
...(Exception only) Principal Technical Analyst - MMIS - Medicaid Pharmacy As a Principal Technical Analyst... ..., including Member, Provider, Claims, Utilization Management, Prior Authorization... ...to support solutioning, testing, and quality assurance. Support performance tuning...ClaimsFull timeRemote workFlexible hours- ...online tools/portals Attach insurance information to unbilled claims and rebill claims that may have gone out to the wrong... ...billing setting Knowledge, Skills, and Abilities Knowledge of Medicare, Medicaid, and Managed Care billing guidelines Experience with Insurance...ClaimsFull timeWork at officeMonday to FridayFlexible hoursDay shift
- ...lives with lines of business in Medicaid, Medicare, commercial, military health... ...Senior Health Data Analyst is responsible for providing... ...responding to regulatory requests, audits, investigations, privacy... ...incidents, and member requests for claims and healthcare information,...ClaimsWork experience placement
- ...with significant disabilities who are seeking to enter or reenter the workforce, and the adjudication of Social Security disability claims for the citizens of Maryland. Grade ASTD15 Location of Position Prince George's County, Metro Business Center, 4451-Z Parliament...ClaimsRemote work3 days per week
- ...A leading claims adjustment firm in Severna Park, Maryland, is seeking Independent Insurance Claims Adjusters. This career offers flexibility, competitive pay, and opportunities for growth. Applicants should be licensed adjusters with experience handling claims. Comprehensive...ClaimsFlexible hours
- A leading risk management company in Maryland seeks a Workers’ Compensation Claims Specialist to join their Creative Risk Solutions team. This role involves managing Workers’ Compensation claims, conducting evaluations, and requiring 3-5 years of relevant experience. The...Claims
$20 - $24 per hour
A professional services firm is seeking a Home Loan Specialist II in Annapolis, MD. Responsibilities include performing daily loan reviews, evaluating loan applications for compliance, and troubleshooting third-party orders. Candidates should have an associate’s degree...Hourly payWork at office$51.8k - $75k
ONE80 INTERMEDIARIES INC is seeking a Claims Accountant in Maryland responsible for managing and analyzing financial transactions related to insurance claims. The role ensures accuracy in claims payments and reporting while complying with regulatory requirements. The successful...Claims- A leading insurance adjustment firm in Maryland is seeking Independent Insurance Claims Adjusters ready to make a difference. This role involves aiding clients in recovery after disasters while enjoying flexibility and competitive compensation. The firm provides comprehensive...ClaimsFlexible hours
- A leading claims adjustment firm in Severna Park, Maryland, is seeking Independent Insurance Claims Adjusters. This career offers flexibility, competitive pay, and opportunities for growth. Applicants should be licensed adjusters with experience handling claims. Comprehensive...ClaimsFlexible hours
- ...A leading claims adjusting firm in Arnold, Maryland is seeking Independent Insurance Claims Adjusters. This role is pivotal in supporting individuals and businesses in their recovery from disasters while offering the flexibility and growth opportunities in a rewarding...ClaimsFlexible hours
$18.5 - $42.35 per hour
...innovative environment dedicated to safety and quality. Join us and help simplify health care... ...activities in support of revenue or claim information. Performs general data gathering... ...of WEX system. Prior experience in auditing. Ability to use knowledge and experience...ClaimsHourly payFull timeTemporary workWork at officeLocal area3 days per week
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