Remote Health Plan Claims Auditor Compliance & Audits
Good Samaritan Society
Good Samaritan Society in Marshfield, WI is seeking a Claims Auditor responsible for performing payment and compliance audits on health insurance claims. The role requires analyzing errors and providing management with reports for process improvement. Applicants should possess a high school diploma, three years of relevant experience, and proficiency in CPT, ICD, and HCPCS coding. The position offers a flexible work schedule and an attractive benefits package. #J-18808-Ljbffr
- ...Remote MSDRG Auditor The DRG Validation Auditor is a member... ...of the CGI Healthcare Compliance, DRG Validation Team,... ...to beneficiaries of health plans, including Commercial... ...underpayments) on paid claims on behalf of the... ...provided specific to audit processes, coding and...Remote workClaimsHealth InsuranceContract workWork at office
$64k - $93k
Join WellSense Health Plan as a Clinical Auditor I, where you'll conduct detailed audits of medical records to ensure accurate reimbursement and compliance with regulations. This remote role is vital in maintaining quality... ...and experience in claims auditing. The compensation...Remote jobClaimsHealth Insurance$80k - $90k
...transparency, and efficiency to health plans. Deployed by over 75... ...on medical review audit work completed by the... ...research, analyzes claims data, applies knowledge... ...-harassment and other compliance and policy/procedures... ...work independently in remote setting with minimum supervision...Remote workClaimsHealth InsuranceFlexible hours- ...Waste, and Abuse Auditor Under the general... ...desk and onsite audits across various provider... ...types to ensure compliance with federal and... ...including data mining, claims analysis, and... ...aspects of the job are remote.... ...degree in business, health care administration...Remote workClaimsHealth InsuranceWork at office
- ...Remote Medical Coding Auditor (CPC, CCS-P, or CPMA) Crossroads Treatment... ...Auditor Conducting audits of claims and patient records... ...proposals and plans. Tracking completion... ...of findings and any compliance issues identified... ...understanding of Mental Health / Opioid Addiction...Remote workClaimsHealth InsuranceTemporary workMonday to FridayShift work
$71.1k - $97.8k
...and help us put health first The... ...Medical Coding Auditor extracts clinical... ...inpatient hospital claims for proper... ...impact WORK STYLE: Remote/work at home. While... ...MS-DRG coding/auditing experience... ...bonus incentive plan. This incentive... ...affirmative action, in compliance with Section 50...Remote workClaimsHealth InsuranceBi-weekly payContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$24.5 - $29 per hour
...Liberty Dental Plan, we are committed... ...the oral health of the communities... ...As an Internal Auditor, you play a critical... ...accuracy, compliance, and continuous... ...improvement across our claims and provider... ...high-volume audits (approx. 1,250/... ...expenses.Remote or hybrid work...Remote workClaimsHealth InsuranceWork at officeImmediate startRelocationVisa sponsorshipFlexible hours$24 - $28 per hour
...integrity, strengthen compliance, and improve how... ...At Liberty Dental Plan, our Internal Audit team plays a... ...analytical Sr. Internal Auditor who brings strong claims or audit... ...opportunity to: Work remotely in a supportive, mission... ...to support mental health and well-being....Remote workClaimsHealth InsuranceWork at officeImmediate startRelocationVisa sponsorshipFlexible hours- ...hybrid (3 days on site, 2 remote) Key Functions 1. Medical record auditing. a. Performs initial... ...to ensure compliance with third party and regulatory... ...Assures compliance with all health plan requirements as related... ...the processing of claims, collections of accounts...Remote workClaimsHealth InsuranceMonday to FridayShift work
- ...Tokio Marine HCC is seeking a full-time Claims Auditor to work remotely in Georgia. The role involves investigating... ...issues. Key responsibilities include auditing submitted claim documents, interpreting health coverage plans, and effectively resolving processing issues...Remote workClaimsHealth InsuranceFull time
$59.3k - $80.9k
...U.S. healthcare company is seeking a Medical Coding Auditor to review medical claims and ensure compliance with coding guidelines. This role involves analyzing... ...years of relevant experience. This position offers a remote work style with competitive benefits and a salary...Remote workClaims$46.99k - $122.4k
...Program Integrity Auditor We're building a world of health around every individual... ...include reviews/audits of provider records... ...funds or rebilling of claims, and referral to... ...member for a health plan(s) which currently... ...rules. Maintain compliance with company policies...Remote workClaimsHealth InsuranceHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- Curative is seeking a Senior Auditor, Healthcare Claims responsible for leading audits and ensuring compliance for its Health Plan. This role impacts operational excellence by improving... ...healthcare accessible while working remotely. We offer competitive benefits,...Remote jobClaimsHealth Insurance
- ...J29, Inc is seeking a part-time Physician Auditor to perform blinded Independent Review clinical evaluations while adhering to Medicare... ...U.S., and familiarity with peer review processes. This is a remote position, creating a flexible work environment. #J-18808-Ljbffr...Remote workClaimsContract workPart timeFlexible hours
$20.78 - $36.53 per hour
...Job Title Remote Position Pay Range:... ...for performing E/M audits, summarizing the results... ...support for Claims Resolution Specialists... ...to Manager/Compliance Officer. Maintain... ...Disaster Recovery Plan. Maintain all company... ...assigned to the Auditor Queue. Audit...Remote workClaims$62.16k - $118.56k
...Tax and Revenue Division: Compliance Administration Opening Date... ...: Office of Tax and Revenue, Audit & Criminal Investigation Administration... ...the time of application, may claim a hiring preference over a non... ...Insurance ~ Retirement Plans (401(a), 403(b) & 457(b)) ~...Remote workClaimsHealth InsurancePermanent employmentFull timeTemporary workWork at officeLocal areaFlexible hours$70k - $75k
...Services & Insurance Attorney Auditor ** This is a fully remote position, and candidates... ...with law firms to discuss compliance with client's billing... ...assistance, flexible spending or health savings account, and other... ...world's leading risk and claims administration partner,...Remote workClaimsLocal areaWork from homeFlexible hours$36.83 - $42.74 per hour
Honest Medical Group LLC is seeking a Risk Adjustment Auditor to ensure the accuracy and compliance of risk adjustment coding for providers and patients. The role requires auditing documentation and claims, identifying inaccuracies, and translating findings into educational...Remote jobClaimsHourly pay- A leading claims administration firm is seeking an Attorney Auditor to review legal and non-legal invoices for accuracy. The position is fully remote, inviting candidates from across the United States... ...independently, ensuring compliance with client billing guidelines...Remote jobClaims
$64.38k - $96.58k
...Company Overview Alignment Health is breaking the mold in conventional... ...Summary Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities... ...CMS guidelines within a health plan, IPA, or managed care environment...Remote workHealth InsuranceFull timeLocal areaMonday to FridayFlexible hours- A leading risk and claims administration partner is seeking an experienced Attorney Auditor. This fully remote position allows candidates from all 50 United States to apply.... ...review legal and non-legal invoices, ensuring compliance with client billing guidelines. A Judis...Remote jobClaims
$37.84 - $58.75 per hour
...Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance... ...Hospital Auditor conducts audits to evaluate compliance with... ...from American Health Information Management Association... ...Union, location, time-off plan policies, availability of health...Remote workHealth InsuranceMinimum wageFull timeWork at officeLocal areaShift work$90k - $100k
...Compliance Auditor Help Protect the Integrity of Healthcare Join C2Q Health Solutions and play a critical role in promoting... ..., and compliance audits across healthcare... ...of the annual audit plan. Design and execute... ...work schedule with 2 remote workdays per week after...Remote workHealth InsuranceTemporary work- American Health Plans Franklin, TN 37067, USA American Health Plans, a division of Franklin, Tennessee... ...Job Duties Conduct pre‑pay and post‑pay audits to ensure accurate claims payments and denials Ensure regulatory compliance and overall quality and efficiency by...Remote jobClaimsHealth InsuranceFull timeTemporary workWork at officeLocal area2 days per week3 days per week
$21.17 - $28.59 per hour
...Responsibilities Provides audit results to... ...correspondence, initial claims, and other... ...ensure consistency and compliance with client... ...internet installed for remote/teleworker. Key... ...vested. Three medical plans (including... ...company contribution to Health Savings Accounts for...Remote workClaimsHealth InsuranceHourly payImmediate start$70k - $75k
A leading risk and claims administration partner is seeking an Attorney Auditor to review legal invoices, ensuring compliance with client billing guidelines. This fully remote position requires a Juris Doctorate and five years of insurance defense or complex litigation...Remote jobClaims- A leading risk and claims administration partner is looking for an Attorney Auditor to review legal invoices and ensure compliance with client billing guidelines. This fully remote position requires a Juris Doctorate and five years of experience in insurance defense or...Remote jobClaims
- ...Coding Auditor Location: Miramar, Florida... ...to improving the health, well-being and, most... ...Responsible for auditing coded inpatient or... ...support the strategic plan and vision of the... ...and resolve claim denials that are rejected... ...and assesses for compliance with AHIMA query...Remote jobClaimsWork experience placementInternshipWork at officeShift work
$64k - $93k
Join WellSense Health Plan as a Clinical Auditor I, where you will perform detailed audits of medical records to ensure accuracy and compliance within a supportive team environment. This role offers a comprehensive salary range of $64,000 - $93,000 based on qualifications...Remote jobHealth Insurance$58.8k - $94.08k
...Conduct comprehensive claims audits to ensure compliance with fee schedules, benefit plans, contractual obligations, service-level... ...administers a diverse portfolio of health insurance products, including... ...preferred:Certified Internal Auditor (CIA) certificationCertified Healthcare...ClaimsHealth InsuranceContract workWork at office
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