Medical Claims Auditor (Fully Remote)
Clover Health
- Remote job
Review claims for billing and coding issues with SIU and Clinical teams. Use AI tools to identify anomalous billing patterns and support prepayment audits. Who you are: CPC with 3+ years of coding and auditing experience. Strong knowledge of CMS regulations, CCI, and Medicare coding. What we offer: Competitive salary, equity, bonus, 401k, and flexible time off. Medical, dental, vision, parental leave, and remote-first culture. Clover Health Clover Health is reinventing health insurance by combining the power of data with human empathy to keep members healthier. It is a fast-growing, remote-first startup with a mission-driven, collaborative culture focused on improving healthcare. #J-18808-Ljbffr Clover Health
$60.1k - $98.7k
...inpatient care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you’ll use your clinical judgment to review medical records, validate...Remote workMedicalClaimsFull time$60.1k - $98.7k
Validate DRG codes from inpatient medical records. Identify coding discrepancies and potential... ...communication, and analytical skills. Fully remote role within the US. Annual salary of $60... ...The company specializes in healthcare claims auditing and analytics, improving...Remote jobMedicalClaims- ...experienced Outpatient Coding Auditor to join our Healthcare... ...expertise to conduct comprehensive medical record audits and identify potential... .... You will review claims across outpatient hospitals,... ...documented audit findings.This is a fully remote position open to candidates...Remote workMedicalClaimsWork at officeLocal area
- ...About This Opportunity: As a Stop Loss Claim Auditor, you’ll review and audit stop loss... ...in healthcare claims, stop loss claims, medical claim auditing, TPA operations, or a related... .... Where You’ll Work: This is a fully remote position, and we’ll provide all the...Remote workMedicalClaimsFull timeContract workWork at officeImmediate startFlexible hours
- Join a team of experienced medical auditors and coders performing audits for government payers. Work remotely in a fast-paced, dynamic, multi-location team. Responsibilities: Audit claims for medical appropriateness and document findings. Draft appeal letters and collaborate...Remote jobMedicalClaims
$85.7k - $129.31k
...Revenue Integrity RN Charge/Coding Auditor is responsible for consulting... ...clinical charge audits of medical records on behalf of... ...will be required as well for fully remote position. Essential Functions... ...knowledge of the healthcare claim denial process. · Demonstrates...Remote workMedicalClaimsHourly payFull timeWork at officeFlexible hours$31.06 - $46.59 per hour
...Billing Compliance, Senior Auditor Reporting to the... ...payer reimbursement for medical services. The Senior... ...resolve risks affecting claim payment, in partnership... ...Hybrid (Evanston, IL and remote) Full Time/Part Time:... ...Endeavor Health is a fully integrated healthcare delivery...Remote workMedicalClaimsHourly payFull timeContract workPart timeFor contractorsMonday to Friday- ...prepayment audits on skilled nursing facility (SNF) claims for government and commercial payers. Work remotely in a fast-paced, dynamic environment as part of a... ...team. Key Responsibilities: Audit claims for medically appropriate services in SNF settings, applying medical...Remote jobMedicalClaimsFor contractorsWork at office
- ...more. Job Description This is a remote position. RN Clinical Auditor - Behavioral Health Location: Fully Remote, with occasional travel... ...Health experience to support medical record reviews and billing... ...issues within psychiatric/BH claims Maintain detailed workpapers documenting...Remote workMedicalClaimsContract work
$66k - $92k
...the Risk Management & Premium Auditor Representative role at SFM -... ...rehabilitation, loss prevention, medical services and more. Though... ...including policy services and claims staff). What We'll Love About... ...jobs in Madison, WI . FULLY REMOTE Audit Manager - Government/Housing...Remote workMedicalClaimsFull timeContract workFor contractorsWork experience placementLive inWork from homeHome officeFlexible hours- ...by our expert, compassionate medical care team at 11 hospitals and... ...Responsibilities As a Coding Auditor, you will be a central figure... ...resolving medical coding claim defects before billing. You will... ...accuracy and efficiency. As a remote employee, we will provide you...Remote workMedicalClaimsWork at officeWork from home
$67k - $76k
...Requistion: Work Arrangement : Remote Compensation Range: $67,000.00 - $... ...The Role: Your Mission: As our next Medical Coding Auditor , you will be responsible for... ...Understanding of billing platforms and claim workflows—how coding feeds into reimbursement...Remote workMedicalClaimsFull time- ...Outpatient Coding Auditor It takes great medical minds to create powerful solutions that solve some of healthcare... ...to perform reviews of multiple claim types to provide a flexible workforce... ...You Should Expect In This Role Remote (work from home) environment within...Remote workMedicalClaimsContract workWork from homeFlexible hours
- EnableComp LLC seeks a Coding Denials Auditor to analyze coded medical services, review claims, and determine coding appropriateness for outpatient and professional... ..., and familiarity with CAC/Encoder audits, with remote work options possible depending on client needs....Remote jobMedicalClaims
- We are hiring nurse auditors who can commit to a minimum... ...for payer-provider claim disputes. Our clients are... ...defensible opinions on medical necessity, coding and billing... ...training so you are fully independent before you... ...technical issues in a remote work environment. Required...Remote jobMedicalClaimsHourly payContract workFor contractorsHome officeOverseasMonday to FridayFlexible hoursShift workNight shiftWeekend workAfternoon shiftWeekday work
- A healthcare technology firm is seeking an experienced Medical Bill Reviewer to work remotely from New York. The role involves reviewing medical claims, analyzing patient records, and ensuring compliance with coding guidelines. Candidates should have at least 3 years of...Remote jobMedicalClaims
- ...provider information and manage documentation requests to audit medical claims, including itemized bills and medical records. The role... ...clients while maintaining strict PHI/PII confidentiality. This is a remote position with cross-team collaboration. Key duties include...Remote jobMedicalClaims
- ...a CPC with 3+ years of coding and auditing experience to review claims for billing and coding issues in collaboration with SIU and Clinical... ...CMS/CCI knowledge and Medicare coding expertise. This is a remote-first opportunity with competitive compensation and benefits from...Remote jobMedicalClaims
$50.7k - $85.9k
...Summary The Coding Compliance Auditor - Hospital, utilizing a strong... ...for admission and discharge claims in order to prevent loss of... ...determine if the information in the medical records is meeting set... ...dust or extreme temperature. Remote The above statements are intended...Remote workMedicalClaimsFull timeWork at office- Humana Inc. is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and accurate DRG assignments.... ...auditing, and cost-conscious payer processes in a remote work setting. Ideal candidates will hold RHIA/RHIT/...Remote jobMedicalClaims
- DaMar Staffing offers a full-time remote Certified Medical Auditor (SC) role focused on validating DRGs, APCs, and Never Events while coordinating rate adjustments with claims teams. The position requires creating monthly and quarterly trend reports, managing records retrieval...Remote jobMedicalClaimsFull time
- Covet Health Inc. is seeking experienced claims professionals for a remote, full-time role. You will handle day-to-day processing and adjudication of medical claims, review documentation, and verify coverage according to plan rules. The position requires 4+ years in a...Remote jobMedicalClaimsFull time
- Optum is hiring a Medical Coding Auditor to verify claims against medical records and ensure compliance with coding guidelines. This telecommuting role... ...and internal teams to maintain quality and production metrics in a remote, production-driven #J-18808-Ljbffr OptumRemote jobMedicalClaims
- Medasource is seeking a Program Integrity Medical Record Reviewer III for a remote contract role. You will conduct line-level medical coding reviews to ensure claims are supported by medical records and compliant with CMS, Medicare, Medicaid, and internal guidelines. The...Remote jobMedicalClaimsContract work
- ...Coding Auditor The Coding Auditor is a professional auditing role... ...strong foundation in primary medical coding and a keen eye for detail... ...and codes billed on a claim to a medical record. Compare... ...career development initiatives ~ Remote work eligible REMOTE WORK...Remote workMedicalClaimsHourly payFlexible hours
- ...POSITION SUMMARY: The Sr Compliance Auditor is responsible for auditing... ...~ Prepares and reviews medical records to assess documentation... ...resource for documentation, coding, claim review process, and billing... ...equipment (in office or remote) ~ Communicate verbally...Remote workMedicalClaimsFull timeWork at officeLocal area
- Humana Inc. seeks a Medical Coding Auditor for the Outpatient Facility/APC Coding Team. You will verify... ...CPT/HCPCS reviews to support correct claims payments. The role requires CPC/COC/... ...experience with operative reports. Remote work with occasional travel for training...Remote jobMedicalClaims
$97.76k - $116.48k
...Overview The Sr. Auditor, Quality Assurance position is responsible... ...ensuring that the audited claims meet quality standards necessary... ..., IRF, HH, DME, Hospice and medical necessity. Quality assurance... ...a qualified candidate is selected. #LI-Remote#LI-JJ1#senior...Remote workMedicalClaimsHourly payWork at officeImmediate startFlexible hours- Humana is seeking an experienced Inpatient Medical Coding Auditor to review inpatient hospital claims and ensure correct DRG assignments for proper reimbursement... ...payments and clear communication with internal teams. Remote/work-at-home arrangement with occasional travel to...Remote jobMedicalClaimsWork from home
- RADcube is seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral... .... You will audit medical records and claims for coding accuracy and compliance, and... ..., AHIMA, and Indiana Medicaid standards. Remote role with occasional travel to Downtown...Remote jobMedicalClaims
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