Hybrid Quality Audit Analyst - Health Insurance Claims
HCSC Group
HCSC is seeking a Quality Audit Analyst in Helena, MT to plan and conduct detailed audits of claims, inquiries, and memberships, ensuring internal controls and Model Audit Rule compliance. You will review transactions and data across Blue Chip systems to verify timely, accurate processing according to standard processes.
The role requires a Bachelor’s degree and 2+ years of health insurance auditing experience or 6+ years in the industry, with strong analytical and communication skills.
#J-18808-Ljbffr$41.7k - $92.8k
## Quality Audit AnalystApply: Flex: MT - Helena: Full time: Posted Today: R0055844At HCSC... ...Review Business Transactions Such As Claims, Inquiry Or Membership, Processes Etc... ...claims, inquiry or membership within the health insurance industry OR 6 years experience...Health InsuranceFull timeContract workWork at officeRemote workFlexible hours$62.7k
...improvements related to the potential of quality medical care and service to members and... .... Perform special studies per audits, conducting office site visits and medical... ...all employees must comply with both the Health Insurance Portability Accountability Act of 1996...Health InsuranceFor contractorsWork at officeLocal areaRemote work$1,000 - $2,000 per month
...We’re not just behavioral health people—we’re crisis people. Connections... ...varied and require extensive insurance billing, follow‑up and appeal... ...validation of denied claims and determines appropriate denial... ...and/or facility billing/auditing within a behavioral health environment...Health InsuranceInsurance claimsFull timeTemporary workPart timeWork at officeImmediate startRemote workFlexible hours$16 - $22 per hour
...and measuring medications, labeling prescriptions, processing insurance claims, handling customer transactions, and assisting customers at... ...Full-time employees may be eligible for benefits including health, dental, and vision insurance, 401(k) with company match, paid...Health InsuranceInsurance claimsHourly payFull timeShift workWeekend workAfternoon shift$181.57k - $241.48k
...provides enterprise-wide leadership across risk management, insurance, surety, claims, contractual risk transfer, alternative risk financing, and... ...industry peers and best practices. Oversee insurance audits and ensure accurate reporting and premium allocations. Manage...Insurance claimsContract workRemote work$500 per month
...research to provide claims status,... ...designed to promote health and well-being. We... ...of shifts based on quality metrics (if shift... ...in: Healthcare, insurance, benefits, and/or... ...volume metrics and audited work. What you... ...more. For our hybrid employees, our on-...Health InsuranceInsurance claimsFull timeWork experience placementWork at officeWork from homeHome officeMonday to FridayShift work$23.51 per hour
...On-SiteWho We Are At Many Rivers Whole Health, we partner with people and communities to... ...they have accurate information about their insurance, eligibility, and financial... ...experience Experience with health insurance claims processing Experience working with an...Health InsuranceInsurance claimsHourly payFull timeFlexible hours- ...Description Job Description Hancock Claims Consultants specialize in Ladder Assist... ...Services, collaborating directly with numerous insurance agencies for efficient claims management... ...claims inspections, and unparalleled quality and precision. Our established process...Insurance claimsPermanent employmentFor contractors
- ...providing expert investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability... ...at mitigating expenses for our clients and delivering high-quality results. We are seeking a detail-oriented and proactive...Insurance claimsFlexible hours
- ...ideal for licensed investigators looking for flexible working hours while providing expert investigative services across various insurance claims. The responsibilities include conducting various investigations, completing video surveillance, and ensuring timely submission...Insurance claimsFlexible hours
$35.5 - $53.25 per hour
...- Integrity Operations: Facility Coding Quality Status: Full time Benefits Eligible... ...experience Will Support: Individual Coder Audits Schedule: Monday - Friday Flexible 1st shift... ...required. Certification from American Health Information Management Association (AHIMA...Daily paidFull timeTemporary workPart timeWork at officeRemote workMonday to FridayFlexible hoursShift workDay shift$23.08 - $37.02 per hour
...Posting Title** Pharmacy Rebate Contract Analyst Associate - Hybrid (Harrisburg, PA) **Job Description** *... ..., billing, rebate, pharmacy, or claims + Pharmacy or Pharmacy rebate operations... ...and are passionate about simplifying health care, let's build the future of pharmacy...Full timeContract workWork experience placementWork at officeLocal areaVisa sponsorshipWork visa1 day per week- ...Highmark Inc. is seeking a healthcare quality/improvement professional to collaborate with compliance, coding, and care-quality teams... ...education across product lines. You will coordinate reviews and audits, support credentialing activities, and help advance STARs and value...
$126.3k - $173.7k
...sits at the intersection of pharmacy, health insurance, member experience, and digital product... ...and measurable outcomes Elevate product quality, standards, and ways of working across... ...at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work...Health InsuranceFull timeTemporary workWork at officeRemote workWork from homeHome office- ...role is ideal for licensed investigators looking for flexible hours while providing expert investigative services for various insurance claims. The ideal candidate will be detail-oriented and capable of conducting investigations including surveillance and special investigations...Insurance claimsFlexible hours
$1,000 - $2,000 per month
...We’re not just behavioral health people—we’re crisis people. Connections Health Solutions... ...with successful quarterly and year-end audits in areas related to payroll and general... ...families) are offered comprehensive health insurance, including Medical, Dental, Vision,...Health InsuranceFull timeTemporary workPart timeLocal areaImmediate startRemote workFlexible hours- ...This role is ideal for licensed investigators seeking flexible hours while providing expert investigative services for various insurance claims. Responsibilities include conducting video surveillance, securing documents, and submitting reports timely. Candidates must...Insurance claimsFlexible hours
- ...offers flexible hours and involves investigating various types of insurance claims, including workers' compensation and suspected fraud. The... ...our team for a dynamic investigative role with a focus on delivering high-quality results. #J-18808-Ljbffr J T Becker & Co IncInsurance claimsFlexible hours
$45.94k - $63.3k
...records. Prepare and process various claims including payroll deductions, direct... .... Payroll processing includes audits, tracking hours, and making changes... ...benefit allowance to help you pay for insurance premiums which include health, dental, life and disability insurance...Health InsuranceFull timePart timeWork at officeFlexible hoursNight shift$48.9k - $66.2k
...navigate Medicare but do not yet have a health insurance license? This fully remote, full-time... ...scripts, workflows, privacy requirements, quality standards, and escalation procedures.... ...at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work...Health InsuranceFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeFlexible hoursShift workNight shift- ...a commitment to work/life balance Potential hybrid remote work arrangement available Health, Dental, and Vision Insurance Access to Montana Health Centers, low-cost clinics... ...law including eminent domain, contract claims, employment law, environmental law, and administrative...Health InsuranceContract workInternshipRemote workRelocation package
- Ensora Health is the leading provider of software and services for mental and behavioral... ...on what matters most: delivering quality care to their clients. As an RCM... ...process denied, rejected, and unpaid insurance and healthcare claims with a focus on accuracy and timely resolution...Insurance claimsWork at office
- ...Representative in Montana's Unemployment Insurance Division, you'll be the... ...service: Provide high-quality, courteous support to Montana... ...few: Work/life balance with hybrid schedules or partial telework... ...and state statutory raises. Health, dental, vision, life insurance...Health InsuranceWork at officeRemote workFlexible hours
$45k - $100k
AO Leadership OpportunityAO offers the ability to work from anywhere, learn from the best in the industry, and become a top earner within the company. AO offers incentives like no other - go on incredible trips, earn prizes - all for just doing your job. AO is seeking ...Health InsuranceRemote work$1,271 - $1,409 per week
...during stressful times ~ Valid Driver's License ~ Background and drug screen Benefits: ~ Health, Dental, and Vision Insurance ~ Customized Housing Options ~ Life and Disability Insurance ~401(k) with Employer Match ~ Certification &...Health InsuranceFull timeContract workImmediate startShift work$62.8k - $78.5k
...workers’ compensation insurance company, we’re... ...participating in claim discussions, and providing... ...services, premium audit, customer service,... ...delivering high-quality, competitively... ...: Excellent health insurance with dental... ...Budget & Financial Analyst We’re unlocking community...Health InsuranceFull timeRemote workFlexible hours- ...INSURANCE ADJUSTER CAREER OPPORTUNITIES Licensed Adjusters & Career-Entry Applicants Welcome No prior insurance adjusting experience... ...interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather...Insurance claimsFull timeFlexible hours
$95k - $125k
...the Montana Commissioner of Securities and Insurance (CSI) as an attorney focusing on... ...CSI’s office in Helena, MT, or potential hybrid or remote work depending on the circumstances... ...State of Montana Benefits : Comprehensive health, dental, and vision coverage for you and...Health InsuranceFull timeWork at officeLocal areaRemote work$21 - $26 per hour
...partner for state departments of insurance, surplus lines associations,... ...Conduct compliance and quality review on documents, state legislation... ...with any surplus lines audits, verifying transactions, documents... ...decisively Perks ~ Health, dental, and vision plans ~...Health InsuranceFull timeRemote work- ...responsible for accurately processing and managing manufacturer warranty claims while providing excellent customer service during the final... ...documentation, and claim history.Assist with warranty audits, reporting, and reconciliation of warranty receivables.Stay informed...Work at office
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