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
$211.55k - $317.33k
...technology firm in the United States is seeking a Senior Medical Director. This pivotal role involves providing strategic oversight for development and improvement of pre-payment edits to ensure robust payment integrity. Candidates must be board-certified physicians with...SeniorClaims$211.55k - $317.33k
...A leading healthcare technology firm seeks a Senior Medical Director to provide strategic oversight for pre-payment edits and improve payment integrity. The role involves collaboration with executive leadership and various stakeholders, ensuring innovative healthcare...SeniorClaimsRemote work- ...insurance company is seeking a Senior Specialist, Coding Auditor to join their Payment Integrity team. This remote position involves... ...issue resolution, ensuring claims repayment quality, and assisting... ...benefits including medical, dental, and unlimited vacation...SeniorClaimsRemote work
$72.04k - $94.55k
...Hi, we're Oscar. We're hiring a Senior Analyst, Payment Integrity Disputesto join our Disputes team. Oscar... ...and issue resolution in the Oscar claim environment for both the Oscar Insurance... ...operations ~3+ years experience in medical coding ~ Medical coding...SeniorClaimsFull timeContract workWork at officeFlexible hours$67.9k - $182.55k
Position Overview The Senior Manager, Medical and Payment Policy Performance Research and Correct Coding Analysis... .... The role partners closely with claims operations to apply policy intent... ...relations - to ensure seamless integration of claims coding changes and resolve...SeniorClaimsHourly payFull timeTemporary workLocal area$216.42k - $324.63k
...relationships, and providing expertise on health plan payment policies. The ideal candidate has over 10 years of experience... ...environment where success is shared. Candidates should have an understanding of claims operations and payment integrity programs. #J-18808-Ljbffr...SeniorClaimsFull time$211.55k - $317.33k
...care by preventing inaccurate payments and reducing overall waste... ...Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified... ...with #YouToThePowerOfAI. Senior Medical Director – Role and Purpose The... ...complex clinical scenarios and claims outcomes. As the primary...SeniorClaimsFull timeFlexible hours$192.5k - $327k
...issues today and address the medical challenges of tomorrow. We strive... ...committed to operating with integrity, driving innovation,... ...social security numbers, or payment of any kind) during the recruitment... ...fraudulent offer or communication claiming to be from AbbVie, please do...SeniorClaimsTemporary workWork at officeImmediate startRemote workMonday to Friday$54.37k - $117.81k
...Molina Healthcare is seeking a Sr. Analyst, Data to join the Payment Integrity Analytics team. The role involves creating and maintaining post-pay reviews of claims to ensure accurate billing. Candidates should have experience with data analysis and reporting, and be familiar...SeniorClaims$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$24.2 - $36.3 per hour
...care by preventing inaccurate payments and reducing overall waste in... ...for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2... ...prevent and recover improper claim payments. This role performs... ...(1) year experience auditing medical claims to identify improper payments...ClaimsFull timeContract workVisa sponsorship$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
...Lyric is seeking a Payment Integrity Analyst (Data Mining) in the United States. This role focuses on investigating... ...year of experience in healthcare, particularly in claims processing and auditing. Knowledge of medical billing codes and strong analytical skills are essential...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...ClaimsContract workRemote work
- ...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
$34.84 - $52.27 per hour
...Lyric is seeking a Payment Integrity Analyst II (Data Mining) to enhance its Data Mining program. The role requires an independent investigator... ...and strong analytical skills, particularly in auditing medical claims. The position offers a salary range of $34.84 to $52.27 per...ClaimsHourly payFlexible hours$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 work- ...A health insurance company is seeking an Operations Associate for its Payment Integrity team to ensure accurate medical claims processing. The successful candidate will have over 3 years of experience with data management and will collaborate across functions to resolve...ClaimsRemote work
$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- ...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
- ...A leading iGaming platform provider in the United States seeks a Senior System Analyst to enhance payment integrations. You will analyse and optimise payment flows, collaborate with stakeholders, and ensure clear requirements for engineering. The ideal candidate has over...Senior
- Oscar Health is hiring a Data Mining Analyst for their Payment Integrity team in New York City. This hybrid position requires the analyst to review claims data, identify incorrect payments, and support quality control. Candidates should have 2+ years of healthcare experience...Claims
- ...Valenz is seeking a Sr. Sales Executive to drive enterprise growth for Payment Integrity solutions within large national and regional health plans. This role requires strategic planning and consultative sales approaches to identify and close complex opportunities. You...Senior
$120k - $140k
...BerryDunn is seeking a Senior Consultant with expertise in Medicaid program integrity and claims audits. The role involves assisting clients in detecting fraud and conducting... ...in Guam. Excellent communication skills and medical claims experience are required. The target...SeniorClaimsWork at officeRemote work- 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
- ...health insurance provider is seeking a Payment Integrity Analyst to support accurate healthcare... ...interpreting payer policies, and analyzing claims to improve payment accuracy. Candidates... ...have a bachelor’s degree, active medical coding certification, and over 3 years...ClaimsRemote job
- ...experienced QA Test Engineering Lead to oversee the quality assurance for their Claims & Money Movement portfolio. This role demands strong leadership and a proven background in testing complex integrated systems, with responsibilities such as defining automation strategies,...SeniorClaims
$150k - $175k
...City, London, and Shanghai. The Senior Manager, Enterprise Integration Strategy & Delivery, will assist... ...being sent by individuals falsely claiming to represent Authentic. These scams... ...for sensitive personal information, payment or banking details as part of the hiring...SeniorClaimsImmediate startWorldwideWeekend workAfternoon shift- Maven-Clinic seeks a Senior Associate, Claims and Benefits Specialist to manage member billing and reimbursement accuracy in New York, NY. This... ..., conducting investigations, and safeguarding financial integrity. Ideal candidates have 4-5 years in healthcare billing and...SeniorClaims
$67.9k - $182.55k
...Hispanic Alliance for Career Enhancement is looking for a Senior Manager in Medical and Payment Policy Performance Research. This role focuses on... ...include collaborating with cross-functional teams, monitoring claims accuracy, and providing expert coding guidance....SeniorClaims
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