Remote Audit Specialist II: ACA and Medicare Claims
$41.7k - $92.8kHealth Care Service Corporation
Health Care Service Corporation is seeking an Audit Specialist Analyst II to lead internal and external audits, ensuring compliance with performance guarantees. Successful candidates will have a Bachelor's degree or equivalent and at least two years of audit experience. The role is remote, emphasizing strong analytical and communication skills, proficiency in audit software, and familiarity with government reimbursement methodologies. Compensation ranges from $41,700 to $92,800 based on experience. #J-18808-Ljbffr
$41.7k - $92.8k
...Job Summary The Audit Specialist Analyst II is responsible for independently... ...Act, Commercial, Medicare and Medicaid... ...ancillary, and professional claims, as well as the... ...Extensive experience across ACA, Commercial, Medicare... ...is a Telecommute (Remote) role. #LI-LI1 #LI...Remote workClaimsWork at office- ...Health Care Service Corporation is seeking an Audit Specialist II to execute audits and ensure compliance with performance guarantees. This remote role requires advanced knowledge of various healthcare reimbursement methodologies. The ideal candidate will have a Bachelor...Remote workClaimsWork at office
$58k - $66k
...ACA/ Internal Auditor II Salary: $58,000 - $66,000 per year SECTION I-JOB DESCRIPTION SUMMARY This position will assist in compliance testing of County Departments; involved in internal audits and the preparation of County Annual Financial Report; develop...SuggestedWork at office- ...Nationwide Mutual Insurance Company is seeking a Field Claims Specialist II, Material Damage for their Sacramento area. This role involves investigating and resolving insurance claims, delivering exceptional customer service, and mentoring less experienced associates....Remote workClaims
$70k - $73k
...AvonRisk LLC is seeking a General Liability and Auto Claims Adjuster II to work fully remotely. The ideal candidate will investigate and evaluate insurance claims while managing a diverse caseload. AvonRisk emphasizes a supportive culture with opportunities for career...Remote workClaims$89.4k - $113.99k
...Internal Auditor II (Full-time Remote, North Carolina Based) The Internal Auditor II provides senior... ...staff advisory, consultative, and audit work to include the preparation of audit... ...functions, particularly as they relate to claims processing, utilization reviews, grievance...Remote workClaimsFull timeContract workTemporary workWork at officeFlexible hours$65.52k - $86k
...Oscar. We’re hiring an Analyst II, Actuarial to join our Actuarial... ...several Affordable Care Act (ACA) markets. You will oversee regularly... .... Work Location This is a remote position, open to candidates who... ...process with respect to IBNR claims, Risk adjustment and Shared Savings...Remote jobClaimsWork at office$64k - $72k
ACS Auto Club Services, Inc. is seeking a Michigan Homeowners Claim Representative II to manage homeowner insurance claims. This role involves handling claims of varying complexity with a focus on resolving coverage questions and ensuring thorough documentation. Candidates...Remote jobClaims- ...Associate II – Medicare Enrollment Support (REMOTE) Job Number: 2025-48339 Category: Administrative Professional Location: Shrewsbury, MA Shift: Day Exempt... ...technical support in the preparation of federal claims for reimbursement Coordinate communications with clients...Remote workClaimsFull timeFor subcontractorShift work
$100k - $300k
...POSITION SUMMARY The Catastrophe Claims Examiner II processes insurance claims for property losses based on coverage, appraisal, and verifiable damage. They interact with independent adjusters and policy holders, review claim forms and other records to determine insurance...Remote workClaimsWork experience placement- ...Job Description Job Description Role Summary The Claims Examiner II/III is a senior-level professional responsible for managing the full... ...reserve management. Location and Work Type Work Type: REMOTE Office Presence: Regular, timely attendance in the office...Remote workClaimsWork at office
$50k - $75k
...Workers’ Compensation Claims Adjuster II - California | 100% Remote Opportunity General Summary The Work comp Claims Adjuster II is responsible for timely... ...achievement. As "America’s small business insurance specialist", we have the resources, a solid reputation and an...Remote workClaimsWork from home- ...Nationwide is looking for a Property Claims Adjuster II to work from home while servicing Northern San Antonio, TX area. The position demands 3-5 years of property claims experience and proficiency in Xactimate. You will handle claims with minimal oversight, making crucial...Remote workClaimsWork from home
$50k - $75k
...A company providing insurance solutions is seeking a Workers’ Compensation Claims Adjuster II for a fully remote position. The ideal candidate will manage workers' compensation claims effectively while adhering to laws and regulations. Responsibilities include evaluating...Remote workClaims- ...Nationwide Mutual Insurance Company is seeking a Claims Specialist II to manage workers' compensation claims in a remote position. The role involves investigating claims, providing exceptional customer service, and ensuring compliance with state regulations. The ideal...Remote workClaims
$24.5 - $26 per hour
...Default FHA Claims QA Analyst II Come join our amazing team and work remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for reviewing FHA mortgage insurance claims for accuracy and submitting the claim form for...Remote workClaimsWork from home- ...Companies, Inc. is searching for a Utilization Management Representative II to manage benefit investigations in a fully virtual role.... ...Responsibilities include determining contract eligibility, managing service claims, and conducting clinical screenings. Benefits include a...Remote workClaimsContract work
$26 - $30 per hour
Med A/Rx is seeking a Medical Coder II to work remotely. The successful candidate will be responsible for accurately coding healthcare claims, analyzing denials, and ensuring compliance with federal and state standards. Candidates must have at least five years of coding...Remote workClaimsHourly pay$23.66 - $33.89 per hour
...Zurich 56 Company Ltd is seeking an RCIS Crop Claims Field Adjuster II to work from a home-based office in Kansas. This position requires 40 hours a week with about 50% travel expected. The ideal candidate should have at least 2 years of experience in crop insurance and...Remote workClaimsHourly payWork at officeWork from home$50k - $86.4k
...damages and otherwise adjusts and negotiates claims within limit of authority. We are seeking... ...increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler, Extended Handler...Remote workClaims- ...technology solutions, audit, investigation,... ...and Compliance Specialist will be responsible... ...experience in auditing Medicare/Medicaid and other... ...10-CM HCPCS level II and CPT codes.... ...Experience in reviewing claims for appropriate... ...checks. ~ For remote work, required to...Remote workClaimsFull timeContract workFor contractorsWork at officeFlexible hours
- Job Information Job Title Claims Representative II- General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt... ...Opportunities Position Location: Home Office, Telecommuting, and Remote Opportunities in: CO, GA, IL, IN, IA, MN, TN, TX, & WI...Remote workClaimsFull timeLocal areaHome officeFlexible hours
$23.66 - $33.89 per hour
...is currently looking for an RCIS Crop Claims Field Adjuster II to work out of the state of Kansas. This... .... Complete claim reviews and audits on lower-level adjusters as assigned.... ...Location(s): AM - Kansas Virtual Office Remote Working: Yes Schedule: Full Time...Remote workClaimsHourly payFull timeTemporary workWork at officeLocal areaWork from homeVisa sponsorship$63.65k - $90.75k
...Programs Actuarial Analyst II position will serve as... ...matter expert for the Medicare and Dual Eligible lines... ...reporting to monitor claims and risk score trends,... ...including annual external audits, DOI audits, and... ...with five 8‑hour days. Remote Type: Hybrid Work Location...Remote workClaimsFull timeWork at officeMonday to FridayShift work$17.24 - $29.57 per hour
...Elevance Health is seeking a Claims Representative II for processing health claims with a focus on efficiency and accuracy. The role offers virtual work flexibility and requires a strong grasp of claims policies. Candidates should have at least one year of claims experience...Remote workClaims- ...System One is seeking a Healthcare Customer Service Advocate II to work in a remote capacity, supporting customers in a call center environment.... ...include answering inquiries about benefits, claims, eligibility, and billing, alongside documenting interactions...Remote workClaimsPermanent employment
- Zurich 56 Company Ltd is looking for a Workers Compensation Claims Specialist II in Parsippany-Troy Hills, NJ. The role involves managing claims... ...range of $59,900.00 - $98,200.00, incentives, and benefits. Remote working is available, supporting flexibility within...Remote jobClaims
$18 - $25 per hour
...Experienced Medical Claims Biller II Position Overview: Are you a seasoned professional with... ...team as an Insurance Claims Follow-up Specialist, where you'll leverage your expertise in... ...verification processes and carrier websites. For remote positions: Reliable high-speed internet...Remote workClaimsHourly payFull timePart time- ...RCM Specialist II The RCM Specialist II is an individual contributor role on the RCM team,... ...payments, processing refunds and credits, and auditing accounts accurately. This role supports... ...-up to resolve unpaid or underpaid claims, denials, and aged balances through appropriate...Remote workClaims
$115k - $125k
...Premium Field Auditor II CopperPoint has an exciting opportunity for a Premium Field... ...Workers' Compensation and General Liability audits across several states, primarily in... ...targets Verify all Workers' Compensation claims as valid and are classified correctly for...Remote workClaimsHourly payTemporary workWork at officeFlexible hours
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