Senior Medical Director, Claims & Payment Integrity
$211.55k - $317.33kColor Employer, LLC
Color Employer, LLC is seeking a Senior Medical Director to provide clinical leadership and oversee the development of payment integrity strategies. This role involves collaborating with executive leadership, clinical teams, and external stakeholders, ensuring that Lyric’s solutions reflect best practices in healthcare. The ideal candidate is a board-certified physician with significant experience in health insurance, strong analytical skills, and a deep understanding of healthcare trends. This full-time position offers a competitive salary range of $211,551.00 to $317,326.00. #J-18808-Ljbffr Color Employer, LLC
$118.69k - $189.91k
Blue Cross and Blue Shield of North Carolina is looking for a Payment Integrity Ideation Lead to drive audit concepts and reimbursement... ...emphasizes using data analysis to reduce overpayments and improve claim accuracy, working closely with various stakeholders. The ideal...SeniorClaims- ...Blue Shield of North Carolina is seeking a Payment Integrity Ideation Lead to drive the creation of... ...opportunities and enhance pre-pay claim accuracy. The role offers a hybrid work model, competitive benefits including medical coverage, and opportunities for career development...SeniorClaims
$216.42k - $324.63k
...relationships, and providing expertise on health plan payment policies. The ideal candidate has over 10 years of experience... ...where success is shared. Candidates should have an understanding of claims operations and payment integrity programs. #J-18808-Ljbffr LyricSeniorClaimsFull time$211.55k - $317.33k
Senior Medical Director Senior Medical Director serves as a pivotal clinical leader within... ...continuous improvement of pre‑payment edits to ensure robust payment integrity. In this capacity, the Senior... ...complex clinical scenarios and claims outcomes. The role is the...SeniorClaimsFull timeFlexible hours$160k - $185k
...enrolled, stay engaged, and are continuously recognized across Maven's platform. You will sit at the intersection of complex data integrations, sensitive member data, and the engagement tools and campaigns that drive activation and retention. This role spans technical...SeniorClaimsPermanent employmentFull timeContract workH1bWork at officeImmediate startRemote workWork visaFlexible hours3 days per week- A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...ClaimsRemote work
$216.42k - $324.63k
...care by preventing inaccurate payments and reducing overall waste... ...for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2... ...clients, engaging directly with medical directors, clinical operations... ...health plan payment policies, claims editing methodologies, and their...SeniorClaimsFull time$24.2 - $36.3 per hour
Color Employer, LLC is seeking a Payment Integrity Analyst to support its Data Mining program by investigating payment errors related to billing... ...role requires at least one year of experience in healthcare claims processing and data analytics. Key responsibilities include...ClaimsHourly pay- ...leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role.... ...Responsibilities include analyzing medical records, handling claims, and utilizing systems like Facets... ...and strong Excel skills. This mid-senior level contract position is perfect...ClaimsRemote jobContract work
$69.38k - $92.28k
MVP Health Care is seeking a skilled data analyst to support payment integrity and analyze healthcare claims data. This position is crucial for uncovering cost savings opportunities and ensuring accurate claims payments while maintaining compliance. Candidates must have...ClaimsRemote job- A healthcare solutions provider is seeking a Business Analyst in New York to support Payment Integrity operations. The successful candidate will analyze claims data, document requirements, and collaborate with stakeholders to improve financial accuracy. A Bachelor's degree...Claims
$29 - $34.25 per hour
Cotiviti is seeking a Payment Accuracy Specialist 2 to enhance healthcare payment integrity through audits and claims recovery. This role requires strong healthcare industry experience... ...competitive benefits including 401(k), medical, dental, and paid time off. #J-18808-...ClaimsHourly pay- ...Senior Executive Assistant You will support senior executives... ...coverage, assistance with new hire integration, facilities maintenance,... ...scorecards Process T&E expense claims for team members. Ensure all... ..., securities services and payments. Corporations, governments...SeniorClaimsWork at officeLocal area
- Senior Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be... ...be responsible for reviewing medical correspondences, analyzing itemized... ...warrants a change in claim payment. This is a non-phone,...ClaimsContract workRemote work
$120k - $140k
BerryDunn is hiring a Senior Consultant focused on Medicaid program integrity and claims audits. The ideal candidate will provide assistance on risk assessments and compliance, conduct audits, and develop corrective action plans. This position allows for remote, hybrid...SeniorClaimsRemote work- EmblemHealth is seeking a candidate for a position that involves analyzing contracts in Enterprise Payment Integrity. This role requires managing vendor relationships and ensuring effective contract management across the organization. The ideal applicant will have a Bachelor...SeniorContract work
$69.38k - $92.28k
...techniques to identify improper payments, uncover cost savings... ...support accurate, compliant claims payment across our health plan... ...claims adjudication, payment integrity operations, or healthcare reimbursement... ..., payment integrity, or Medical Economics, especially in Medicare...ClaimsLocal areaRemote work$200k - $230k
...enterprises, and agentic platforms to integrate stablecoin rails with speed,... ...Full-time Salary range Senior level: 200,000 - 230,000 USD... ...Engineer on the Agentic Payments Team, you will build and scale... ...If you receive an email that claims to be from Crossmint but ends...SeniorClaimsFull timeContract workTemporary workPart timeWork at officeFlexible hours$206.25k - $343.75k
## US Senior Medical Director, Rare HematologyApplylocations: Cambridge, MA: Morristown, NJtime type: Full timeposted on: Posted Todaytime left... ...teams regarding strategy, tactics, and development of claims* Serve as the internal expert for rare hematologic conditions...SeniorClaims$105k - $150k
## Senior Corporate ParalegalApplylocations: 199 Watertime... ...hospitality offerings integrated into one-of-a-kind... ..., including Board of Directors materials (via... ...charts, and franchise tax payments in coordination with CSC... ...administrative insurance claims management (preferred,...SeniorClaimsContract workWork at office$65 - $75 per hour
Transcarent is looking for a Senior Product Manager to own the product... ...and roadmap for our data integration platform that powers the... ..., governing how eligibility, claims, pharmacy, and other enterprise... ...not limited to: Competitive medical, dental, and vision coverage...SeniorClaimsContract workRemote workFlexible hours- Providence is seeking a Remote Research Analyst responsible for improving claims payment accuracy within their Health Plan. Ideal candidates will have a Bachelor's Degree or equivalent experience and at least 3 years of relevant experience in claims processing and healthcare...ClaimsRemote job
- ## Workers Comp Senior Claims Specialist Remote -CA WC CLAIMSApplylocations... ...out our company values of integrity, transparency, fairness,... ...external partners.* Authorizes payments in accordance with assigned... ...employees have access to medical, dental, and vision coverage...SeniorClaimsFull timePart timeSeasonal workLive outWork at officeRemote work
$92.7k - $139.1k
...you’re at in the organization, you’re an integral part of our team and your input,... ...Conduct complex, in‑depth analysis of claim payments and its methodology, identifying trends... ...s) and providers as applicable. Ensure medical claims, records, and other documentation...ClaimsContract workWork at officeRemote workWork from homeFlexible hoursShift work2 days per week1 day per week- medical insurance, paid time off, 401(k) United States Location... ...primary objective of the Senior Revenue Cycle Billing... ...recover outstanding payments from aging medical insurance claims, whether working in an office... ...Safeguard the accuracy and integrity of all billed claims...SeniorClaimsRemote jobWork experience placementWork at officeLocal area
- ...professional liability and litigated claims, as well as commercial injury... ...and reviews invoices for payment; Provides producer inquiry... ...data standards and data integrity (enters and maintains complete... ...physical or mental disability, medical condition, marital status, age...SeniorClaimsWork at officeLocal area2 days per week
- An innovative nonprofit organization in the United States is seeking a Senior Integration Engineer to advance data interoperability in public health. This role involves designing robust interfaces, supervising integration engineering teams, and ensuring compliance with...SeniorRemote job
$200k - $270k
Join to apply for the Associate Medical Director, Cardiology role at Cohere Health . Opportunity... ...our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an... ...authorization data with post‑service claims validation, we’re creating a transparent...ClaimsRemote workFlexible hours$120k - $150k
...Title Senior Analyst – Accounting & Healthcare Reimbursement Compensation $120,000–$... ...and compliance Oversee reconciliation of claims, payments, and final settlements—producing... ...system‑wide reimbursement and revenue integrity Must-Have Skills/Experience (Required)...SeniorClaimsLocal areaMonday to Friday$54.37k - $117.81k
...JOB DESCRIPTION This role will be a member of the Payment Integrity Analytics team who is responsible for creating and maintaining a post pay review of claims, members, and providers to ensure accurate billing. Our team creates Post Pay Concepts (Analytics) that identify...SeniorClaimsWork experience placement
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