Healthcare Claims Auditor & Compliance Specialist
CVS Health
CVS Health is looking for a Program Integrity Auditor in Phoenix, Arizona. This role involves reviewing medical records to ensure compliance with coding standards and identifying any fraudulent activities. Candidates should have 3-5 years of experience in claims data, be knowledgeable in coding guidelines, and hold an active CPC, CCS, or CPMA license. The ideal applicant will have strong analytical skills and the ability to work independently as well as collaboratively. This full-time position offers a competitive salary and a comprehensive benefits package. #J-18808-Ljbffr CVS Health
$71.1k - $97.8k
...The Inpatient Medical Coding Auditor extracts clinical information... ...to review inpatient hospital claims for proper reimbursement, handle... ...personal wellness and smart healthcare decisions for you and your... ...take affirmative action, in compliance with Section 503 of the Rehabilitation...ClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...as but not limited to: Customer Service, Claims Processors, and Correspondence positions):... ...Experience 5 years of experience working within a healthcare and/or management care 2 consecutive years’ experience as an RN analyst or auditor in Utilization Review, Medical Claim...ClaimsFull timeWork experience placementRemote work1 day per week
- ...® Health is the platform to simplify healthcare – the destination for employers, payers... ...Opportunity: As a Certified Medical Claims Auditor (Clinical Bill Review Analyst), you’ll... ...and client satisfaction. Ensure compliance with HIPAA and other regulatory standards...ClaimsFull timeImmediate startRemote workFlexible hours
- ...Professional to leverage financial expertise in supporting fiscal health. This role includes analyzing financial data and ensuring compliance in claims processing. The ideal candidate will have a strong background in electronic billing, excellent analytical skills, and...Claims
- ...processing. The role involves processing insurance claims, handling patient accounts receivable, and ensuring compliance with relevant regulations. Candidates should... ...ranges. Join us to contribute to our dedicated healthcare team. #J-18808-Ljbffr Palo-Verde-Hematology-...Claims
$46.99k - $122.4k
...The Program Integrity Auditor is responsible for reviewing... ..., and other healthcare providers to determine... ...of funds, rebilling of claims, and referral to state... ...documentation rules. Maintain compliance with company policies... ...CCS (Certified Coding Specialist), or CPMA (Certified...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- A healthcare organization based in Phoenix, AZ, is seeking a claims analyst to review and process Stop Loss claims. The role involves building client relationships, analyzing claim losses, and ensuring compliance with policy standards. Candidates should have at least 5...Claims
- ...ensuring the integrity and accuracy of claims processes and protocols. Collects data for... ...findings, ensuring accuracy and compliance with legal and regulatory requirements.... ...4 years preferred Prior experience with healthcare fraud investigations required Familiarity...ClaimsWork experience placement
$17.32 - $26.85 per hour
...As an Insurance Collector, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers. Every... ...health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20...ClaimsWork at officeWork from home- ...surgical centers. Overview As an Insurance A/R Specialist, this position collects payments for an... ...up with insurance companies and ensures claims are paid/processed. Works all accounts... ...Experience: 2 years medical billing or healthcare insurance follow up experience Skills...ClaimsContract work
- A cleanroom technology provider in Phoenix, Arizona is seeking an AMC Auditor responsible for servicing client mechanical teams and ensuring AMC quality control. The role involves monitoring data, conducting audits, and supporting cleanroom operations. Candidates should...
- La Mesa RV Inc in Phoenix, AZ, is seeking a Workers’ Compensation Specialist to manage the lifecycle of claims while ensuring compliance. You will support employees through work-related injuries, maintain organized case records, and collaborate with various departments...Claims
- ...Summary Ensures the integrity and accuracy of claims processes and protocols. Collects data... ...findings, ensuring accuracy and compliance with legal and regulatory requirements.... ...providing training and support to other auditors/investigators, contributing to the continuous...ClaimsWork experience placement
- ...regulations Partner on complex, cross‑divisional initiatives to assess compliance impacts of products and operational activities Create... ...with Legal, Compliance, IT, Partner Management, Operations, and Claims Qualifications Demonstrated experience providing customer‑...Claims
- Overview Ortho Operations Auditor Are you ready for your next careeradventure... ...an impact to join CHOICE Healthcare Services, where our mission... ...consistency, accuracy, and compliance with company standards. This... .... Audit insurance claims and payment posting in collaboration...Work at office
- ...Health as a Senior Billing Specialist, where your expertise in complex... ...ensure clean, compliant claims and maximizes reimbursement.... ...delivering integrated, whole-person healthcare while strengthening the... ...ensuring timely filing compliance. Handle specialized billing...ClaimsTemporary workInterim roleMonday to FridayFlexible hours
- ...delivering integrated, whole-person healthcare. In this role, you will help produce clean, compliant claims the first time by ensuring... ...to maintaining HIPAA compliance and protecting patient information... ...primary care providers and specialists. Our unique service integration...ClaimsTemporary workMonday to FridayFlexible hours
$40k - $52.3k
...requests. Research and interpret insurance claims, while using a broad array of clinical... ...prior authorization requests, ensuring compliance with quality standards and departmental... ...encourage personal wellness and smart healthcare decisions for you and your family while...ClaimsFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeShift work$43.8k - $62.5k
...Medical Claims Recovery Specialist (Subrogation) - Hybrid Arizona Date: Jul 8, 2026 Location: Phoenix... ...identify, verify, and coordinate healthcare coverage for Medicaid members, while... ...revenue recovery, accuracy, and program compliance. What we're looking for High School...ClaimsFull timeWork at officeRemote workMonday to FridayFlexible hours- Choice Healthcare Services, a leading pediatric dental provider in the Southwest, is seeking an Ortho Operations Auditor to enhance operational excellence across multiple practices. You will audit clinical and financial workflows, identify process improvements, and support...
- ...exclusive features. Reports to: Corporate Compliance Officer About Us: Yrefy is a dynamic... ...Duties/Responsibilities: The Compliance Specialist position will help create and manage... ...Compliance Position in Phoenix; 5+ years of Healthcare Exp; 3 yrs Compliance Exp Phoenix, AZ $...Full timeWork at officeRemote workFlexible hours
$65k - $85k
...Inflation Reduction Act (IRA) compliance requirements in regards to Domestic... ...team, vendors, and IRA Auditors to manage IRA compliance. The Compliance Specialist will provide audit information... ...ESPP) Flexible spending account (Healthcare & Dependent care) Health & Wellness...Contract workTemporary workApprenticeshipWork experience placementFor subcontractorWork at officeLocal areaFlexible hours- ...in the country — from semiconductor and healthcare facilities to professional sports venues... ...management program — from insurance strategy and claims oversight to safety alignment and... ..., coverage adequacy, and contractual compliance. Oversee subcontractor and vendor Certificate...ClaimsWeekly payContract workFor contractorsFor subcontractorH1bLocal areaVisa sponsorshipWork visa
- ...A healthcare solutions company is seeking a Medical Billing and Collection Specialist to manage a range of billing functions, including claim submissions and payment posting. The role requires at least 2 years of experience in healthcare billing, with a strong focus on...ClaimsRemote work
$35 - $45 per hour
Datavant is seeking a Profee Auditing Specialist to perform coding audits and enhance educational... ...support related to coding quality and compliance. Candidates should have over 5 years of... ...to contribute to transformative healthcare data solutions. #J-18808-Ljbffr DatavantRemote jobHourly pay$28 - $35 per hour
...Coding Auditor/Educator Contract to hire Acclivity Healthcare Your personable, proven partner! Since 1999, Acclivity Healthcare has served the specialized... ...to maximize accuracy completeness and compliance with accepted standards of practice and current coding...Hourly payFull timeContract workLocal areaRemote workWork from homeMonday to Friday- ...Ensures interpretation and compliance with the appropriate accrediting... ...including verifications and claims history as required ~... ...Responds to inquiries from other healthcare organizations, interfaces... ...Provider Credentials Specialist (CPCS) preferred. Knowledge...ClaimsFull timePrivate practiceImmediate startMonday to Friday
$57.4k - $99k
...experience The Physician Coding Auditor develops and implements strategic needs... ...Immediately provides reports related to compliance risks when requested. Experience... ...Coder) CCS-P (Certified Coding Specialist-Phys Based) CCS (Certified Coding Specialist...Temporary workWork at officeImmediate startRemote work$22.3 - $35.2 per hour
...ensuring accurate and timely processing of claims, including denials and the maximization... ...and accuracy in AR operations. Ensure compliance with company policies, accounting... ..., preferred in business administration, healthcare or related field 3-5 years of experience...ClaimsHourly payTemporary workWork at officeLocal areaFlexible hours$63.59k - $121.53k
...and investigate life, health, and annuity claims to ensure claim validity and to protect... ...of Insurance fraud reports in compliance with established regulatory guidelines and... ...spouse/domestic partner 5 or more years healthcare/insurance claim investigations experience...ClaimsFull timeContract workH1bWork at officeRelocation packageFlexible hours
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