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
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- NACBA is seeking a Program Integrity Auditor to review Medicaid claims and ensure compliance with coding and documentation standards. Responsibilities include serving as an audit team member, identifying billing patterns, and providing education to providers. The ideal...ClaimsFull time
$46.99k - $122.4k
...time. Position Summary The Program Integrity Auditor is responsible for the... ...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...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$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- ...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
$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$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$114k - $143k
...Senior Consultant - Capital Markets, Program Manager Location: NYC, USA (Onsite) | Practice Area: Business Consulting | Type: Permanent Lead a global... ...distributed delivery Familiarity with regulatory, audit, and risk-controlled environments Experience...SeniorPermanent employment$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$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$101.5k
...growth. Job Title Senior Consultant, Life Sciences &... ...Kickback Statute, False Claims Act, HIPAA, Corporate Integrity Agreements, etc.); Skilled... ...in healthcare compliance program elements, risk assessments... ..., monitoring, and auditing. The salary wage range...SeniorClaimsTemporary workWork at officeLocal areaFlexible hours$90k - $188.1k
...Permanent Full Time Title: Senior Life Insurance Business Consultant Category: Business... ...across strategy, systems integration, and managed services. With... ...underwriting, servicing, and claims. Required Qualifications... ...Wellness and Well‑being programs Equal Opportunity Statement...SeniorClaimsPermanent employmentFull timeLocal areaWorldwide$102k - $170k
...Job Family:**Technology Consulting**Travel Required:**Up... ...What You Will Do:*****Senior Consultant***We are... ...registration through claims management and collections... ...HIPAA, Medicare/Medicaid guidelines)* Proficiency... ...Certifications* Employee Referral Program* Corporate Sponsored...SeniorClaimsTemporary workRemote workFlexible hours- ...provider based in Idaho is seeking a Payment Accuracy Specialist 2 to join their dynamic team. This role involves auditing client data to generate recoverable claims while training team members and developing new audit concepts. Successful candidates will have a high school...SeniorClaimsWork at office
- Senior Solutions Consultant (Pre-Sales Engineer)Professional firms navigate complex... ..., security protocols, and integrated data is essential — as is... ...and flexible time off programs and our benefits are designed... ...not responsible for any claims, losses, damages, or expenses...SeniorClaimsLocal areaFlexible hours
$69.7k - $94.3k
...dedicated team of Coding Consultants are living our mission... ...member of the Payment Integrity team, our Coding... ...coordinates, monitors, and audits documentation and... ...expertise didn't just process claims — it actually shaped... ...-supported outreach programs. Connect with...ClaimsWork at officeImmediate startWork from homeFlexible 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- ...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
- ...Senior Social Media & Influencer Strategists SoHo... .../Creator Marketing program—responsible for sourcing... ...including objectives, hooks, claims, do’s/don’ts, and full... ...content creator or integrated marketing role with hands... ...for boosts with audit-ready records A steady...SeniorClaimsFull timeFixed term contractWork at officeImmediate start
- ...Second Nature is seeking a Sr. Manager of Insurance Program to lead insurance operations for the organization. This role involves managing teams, overseeing claims processes, and ensuring operational excellence. The ideal candidate has over 5 years of experience in insurance...SeniorClaimsRemote work
$56k - $94k
...the Director of Revenue Integrity, the Revenue Integrity... ...subject to pre-bill claim edits, hospital billing... ...of Medicare, Medicaid, and other third-party... ...Hospital medical billing and auditing experience Associate's... ...Certifications Employee Referral Program Corporate Sponsored...ClaimsTemporary workRemote workFlexible hours$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- ...responsibilities include? Serves as a risk consulting account manager and interfaces with... ...pollution conditions and environmental claim risks. Provides underwriting submission... ...State, and local environmental regulatory programs. Provides analysis of pollution-related...SeniorClaimsFor contractorsWork at officeLocal area
- Responsible for revenue recognition for al Medicaid fee for service and Third-Party payor programs, Accounts Receivable account... ...uploads. Preparation of annual audit lead scheduled for outside... ...conduct, the NYS and federal false claims acts, whistleblower protections and...SeniorClaimsTemporary workShift work
$116.88k - $148.13k
...Senior Consultant– Digital Innovation, Solution Expansion and Value Realization (Commercial Transformation... ...support. Solution Packaging and Integration – Analyze and modularize solutions to... ...with health care data stack (claims, HER, prescription data, specialty data...SeniorClaimsFull timeTemporary workLocal area$211.55k - $317.33k
...leading healthcare technology firm in the United States is seeking a Senior Medical Director. This pivotal role involves providing... ...and improvement of pre-payment edits to ensure robust payment integrity. Candidates must be board-certified physicians with at least 10...SeniorClaims- ...Senior Solutions Consultant (Pre-Sales) I At Nielsen, we are passionate about our work to power... ...Consumption Sales teams to drive deep integration of N1Ads & Outcomes into client workflows... ...domain. Be cautious of any outreach claiming to be from Nielsen via other...SeniorClaims
$77k - $202k
...Workforce Solutions - Rewards - Compensation Consultant - Senior Associate, you will engage with clients... ...compensation structures and incentive programs to enhance employee engagement... ...workforce compensation trends Supporting claims management systems and payroll software...SeniorClaimsFull timeH1b$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
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