Medicaid Program Integrity & Claims Audit Senior Consultant
$120k - $140kBerryDunn
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 audits while ensuring compliance with federal regulations. Remote, hybrid, or office work is available, primarily assisting clients in Guam. Excellent communication skills and medical claims experience are required. The target salary range is $120,000 - $140,000, based on qualifications and experience. #J-18808-Ljbffr
$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$120k - $140k
...Overview BerryDunn is seeking a Senior Consultant with subject matter expertise in Medicaid program integrity and claims audits to assist clients with prevention and detection of fraud, waste, and abuse. This individual will be responsible for assisting with risk assessment...ClaimsRemote work- ...Stryker Corporation seeks a Program Integrity Auditor who will review records for various healthcare providers, ensuring compliance... ...and documentation standards. Responsibilities include auditing Medicaid claims and providing education to providers on coding rules. The...Claims
$46.99k - $122.4k
...Position Summary The Program Integrity Auditor reviews records for medical... ...records. Activities include audits of provider records to ensure... ...of funds, rebilling of claims), and referral to state regulators... ...that administer benefits to Medicaid members across multiple...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...Alliance for Career Enhancement is hiring a Program Integrity Auditor in New York, NY. This full-time position involves auditing medical records for compliance with coding standards... ...will have 3-5 years of experience in claims data review, industry coding guidelines, and...ClaimsFull time
$46.99k - $122.4k
Hispanic Alliance for Career Enhancement in Georgia is hiring a Program Integrity Auditor responsible for auditing healthcare records. This role requires 3-5 years of experience in claims data review and medical coding standards (CPT, HCPCS, ICD-10). Candidates should hold...Claims$46.99k - $122.4k
...Hispanic Alliance for Career Enhancement is seeking a Program Integrity Auditor based in New Jersey. This role involves auditing medical records to ensure coding accuracy and... ...candidate will have 3-5 years of experience in claims data interpretation and hold certifications...ClaimsFull time- ...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... ...have 1+ years of coding or auditing experience and a CPC designation...SeniorClaimsRemote work
- ...Blue Shield of North Carolina is seeking a Payment Integrity Ideation Lead to drive the creation of new audit concepts and reimbursement policies. You will leverage... ...cost avoidance opportunities and enhance pre-pay claim accuracy. The role offers a hybrid work model,...SeniorClaims
$140k - $180k
...Come build that future at Cresta. ABOUT THE ROLE The Senior Brand & Integrated Campaigns Manager is a brand-new role at Cresta. Your job... ...will always come from the @cresta.ai domain. Any outreach claiming to be from Cresta via other sources should be ignored. If...SeniorClaimsWork at officeRemote workWork from homeHome officeFlexible hours$124.5k - $165k
...We are recruiting for a Senior Consultant, Healthcare Informatics for... ...opportunity to contribute as an integral member of a project team applying... ...familiarity with healthcare claims, pharmaceuticals, and... ...Familiarity with Python and programming large scale data solutions preferred...SeniorClaimsImmediate startRemote work$90k - $188.1k
...Senior Life Insurance Business Consultant Category: Business Analysis (functional... ...across strategy, systems integration, and managed services. With... ...underwriting, servicing, and claims Required... ...Wellness and Well-being programs Skills: Business...SeniorClaimsFull timeLocal areaWorldwide$112.6k - $265.88k
...Capgemini Invent - Senior Consultant - Banking/Insurance Transformation Strategy... ...and execution of strategic programs that shape the future of the... ...policy administration to claims, billing, distribution, and... ...partners, systems integrators, and client teams to ensure...SeniorClaimsPermanent employmentFull timeContract workLocal areaFlexible hours$101.5k
...and professional growth. Job Title Senior Consultant, Modeling and Analytics, Life... ....g., Anti-Kickback Statute, False Claims Act, HIPAA, Corporate Integrity Agreements, etc.); Excellent written... ...Holidays per year and a generous PTO Program Family Support including Paid...SeniorClaimsTemporary workWork at officeLocal areaFlexible hours$125k - $150k
...application process. Senior Director of... ...and innovative programming to children, youth... ...reimbursement claims, billings, and audits. The Senior Director... ...payments; Medicaid, managed care and... ...and expenditures. Consulting with the Board Investment... ...professional integrity. Innovative and...SeniorClaimsFull timeContract workLocal area$75k - $85k
...Location and Job Title: Senior Accountant/Assistant... ...agencies, development of program and administrative budgets... ...staff, forecasting, audits and reporting). The position... ...filings (i.e. claims, budgets, budget modifications... ...); Ensuring the integrity of financial results related...SeniorClaimsContract workFlexible hours$140k - $180k
...the world. Job Description Our Program Advisory business, set up in 2018, offers... ...recruit a strategic and experienced Senior Consultant. In this client-facing role you will... ...project lifecycle. Working as part of an integrated team; leading workstreams (up to...SeniorFull timeContract workFlexible hours- ...leading authority in payment integrity solutions. Payment... ...SNF Payment Integrity audit product. This role is ideal... ...as well as shaping a program that is clinically... ...documentation and state Medicaid policies. Monitor regulatory... .... Define and validate claim selection logic, risk...Claims
$116k - $136.5k
...West Monroe is currently seeking a Senior Consultant to join our Operations Excellence practice... ...office stand-up/execution, program/project management of key workstreams,... ...supporting methodologies and tools, as well as integrating these with other consulting solutions...SeniorInternshipWork at officeLocal areaImmediate startFlexible hours$107.9k - $172.64k
...Description The Provider Education Program Manager is responsible for... ...outliers. This role uses claims, coding, and reimbursement data... ...; and partners with Payment Integrity, Provider Relations, Compliance... ...in managed care, Medicare, Medicaid, Marketplace, or commercial health...ClaimsWork at officeLocal areaRemote workFlexible hoursShift work2 days per week$128.1k - $239.6k
...the world, the EY security consulting practice supports digitally-... ...other words, it is not just an audit or oversight role, but one... ...Security – Experience with the integration of common infrastructure... ...Source web technologies and programming languages, preferable with experiences...SeniorWork experience placementSummer holidayLocal areaFlexible hours$125k - $150k
...policy analysis, program development, performance... ...Summary: The Senior Director will be responsible... ...of quarterly claims for EI program to... ...data and integrity for revenue maximization... ...grant and other Medicaid Administration claiming... ...closeout and audit activities.* Respond...SeniorClaimsFull timeWork at officeLocal area$140k - $160k
...care. About the Role As the Senior Social Media Manager at VSCO,... ...launch and optimize social media programming, such as influencer... ...trends and monitor sentiments to integrate VSCO into relevant community... ...receive outreach from someone claiming to work for VSCO, please verify...SeniorClaimsTemporary workLocal areaImmediate startRemote workFlexible hours$89k - $148k
...Family:**Finance & Accounting Consulting**Travel Required:**Up to 75%+... ...role, you’ll lead revenue integrity consulting projects, guide clients... ...charging** environments.***Senior Consultant***At Guidehouse,... ...Certifications* Employee Referral Program* Corporate Sponsored Events &...SeniorTemporary workRemote workFlexible hours$95k - $125k
...workers’ compensation, along with claim services. Preferred location:... ...all technical aspects of audits—from initial assignment,... ...underwriting teams to enhance existing programs and improve overall premium... ...team member committed to integral participation in a team atmosphere...SeniorClaimsWork experience placementRemote workFlexible hours$46.99k - $122.4k
...Alliance for Career Enhancement is seeking a Program Integrity Auditor to ensure compliance with... ...records. This role requires 3-5 years of claims data interpretation experience and an... ...CPMA license. Responsibilities include auditing records, identifying billing patterns,...ClaimsFull time$67.9k - $149.33k
...key member of the Medical Policy & Program Solutions team, the Senior Manager, Health Services plays a critical... ...business by leading clinical and claims-focused initiatives that drive... ...compliance, and cost management across Medicaid and Duals lines of business. The position...SeniorClaimsHourly payFull timeTemporary workWork at officeLocal areaRemote work$70k - $150k
We do Consulting Differently The Healthcare Compliance... ..., and compliance auditing for healthcare... ...compliance programs and auditing of billing... ...documents and claims documents. This position... ...as Medicare and Medicaid. Responsibilities... ...directed by more senior managers; Demonstrate...ClaimsWork experience placementWork at officeLocal area$68.04k - $118.8k
...Cause Analysis (RCA) to resolve payment integrity issues to resolution. Initiate project requests... ...and accruals for each Payment Integrity program, to ensure program alignment with budget... ...projects and assignments. Initiate claims to determine under and overpayments,...SeniorClaimsContract workInterim roleRemote work- ...to join our growing Solution Consulting team across the EMEA region.... ...Impact Engage strategically with senior executives (C-level) and key... ...teams to deliver integrated, effective client solutions.... ..., emails and correspondence, claiming they are representatives of Anaplan...SeniorClaims
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