Quality Audit Analyst II - Medicare/Medicaid Claims
$21.1 - $49.08 per hourHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is seeking a customer-focused individual for Medicare/Medicaid Claim Processing. The ideal candidate has over a year of relevant experience and strong analytical skills. Responsibilities include quality audits, managing performance guarantees, and ensuring compliance with SOX. This full-time role offers a hybrid work model and a comprehensive benefits package. The typical pay range for this position is $21.10 - $49.08 per hour. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$21.1 - $49.08 per hour
...accountable and prioritize safety and quality in everything we do. Join us... ...for Aetna performs quality audits for service operations for... .... Government Programs Claim Quality is an exciting and... ...SOX and Sarbanes control for Medicare and Medicaid Claim Processing. We are looking...ClaimsHourly payFull timeWork at officeLocal areaFlexible hours3 days per week- ...knowledge of insurance plans, including Medicare and Medicaid. Strong working knowledge of ICD-10 and... ...coding. Strong working knowledge of claim appeals, denials, and their processes.... ...Maintain computer office notes for clear audit trail on every account worked. Maintains...ClaimsWork at office
$14 - $17 per hour
...purchases 500 Daybreak Cash Reward to claim each month Special membership... .../Community) 1 Job Available – Quality Assurance Team, Austin, Texas... ...Position Title: QA Analyst (Temp) Studio/Department: DC Universe... ...EverQuest and EverQuest II games. This is also the home of...ClaimsHourly payTemporary workLocal areaWorldwideNight shift$5,425.33 - $8,866.16 per month
...Quality Data Analyst (17242) Posting ID: 17242 Functional Title: Quality Data Analyst Job Title:... ...and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a... ...improvement, conducts analyses using claims, clinical data, and data from other analytic...ClaimsWork at officeRemote workShift work$5,425.33 - $8,866.16 per month
...at HHS webpage. Functional Title: Quality Data Analyst Job Title: Data Analyst IV Agency:... ...and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a... ...from a variety of sources, including claims and clinical data from regional health...ClaimsFull timeTemporary workPart timeFor contractorsWork at officeRemote workShift workDay shift- ...practices facilitating access to high‑quality, diagnostic‑driven patient care. EPG is the claims‑based provider network for... ...states: AR, GA, MS, TX, WI, LA, AL). Medicaid enrollment in multiple states... ...in and in good standing with Medicare. Demonstrated ability to deliver...ClaimsContract workRemote workFlexible hours
- ...A leading personnel solutions organization is looking for a candidate to assist Medicaid clients and providers with questions related to eligibility and claims. The role requires excellent communication skills, a courteous demeanor, and the ability to document encounters...Claims
$59.3k - $80.9k
...Medical Coding Auditor reviews medical claims submitted against medical records... ...: Experience with coding/auditing multispecialty surgical procedures... ...efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military...ClaimsFull timeTemporary workApprenticeshipRemote workWork from home- US staffing Inc is seeking an experienced Business Analyst for Medicaid Systems and Claims Processing in Austin, TX. This role involves delivering solutions that meet operational requirements and coordinating with teams to manage expectations and project deliverables. The...Claims
$70.1k - $126.2k
...including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: The Senior HEDIS Quality & Audit Analyst serves as an enterprise subject matter expert responsible for advanced HEDIS quality oversight, audit readiness, and...Full timePart timeH1bWork at officeRemote workWork from homeFlexible hours- ...Nationwide Mutual Insurance Company is looking for a Property Claims Adjuster II to work from home in Austin, TX. This role involves managing property claims, conducting inspections, and ensuring customer satisfaction. The ideal candidate will have 3-5 years of experience...ClaimsRemote workWork from home
$60k - $90k
...supplement strategy, and carrier-facing claim execution across our platform. This is... ...Identify opportunities to improve estimate quality, supplement success rates, and cycle time... ...High attention to detail and ability to audit estimates for completeness and accuracy...ClaimsLocal area$65k - $75k
...Operations to ensure that cash pay invoicing, contracting, and insurance claims are accurate, timely, and reimbursed in full. The ideal... ...billing and revenue reports for leadership review. Assist with audits and ongoing billing process improvement initiatives. Support the...ClaimsFull time- Curative is seeking a Senior Claims Integrity & Quality Analyst in Austin, Texas to enhance claims accuracy and operational excellence in healthcare. This role involves conducting detailed audits of complex claims, collaborating with various operational teams, and utilizing...ClaimsRemote job
- ...are committed to collaboration, high-quality patient-centered care, and... ...across our growing network. Job Duties Audits and ensure claim information is complete and accurate... ...of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc. Knowledge...ClaimsFull timeWork at office
- Valid8 Financial, Inc. is looking for a Senior Claims Integrity & Quality Analyst to enhance claims accuracy and operational excellence. This position plays a key role in auditing claims, ensuring compliance, and innovating within the claims organization. The ideal candidate...ClaimsFlexible hours
- Business Analyst - Medicaid Systems and Claims Processing Internal Job ID: TWK_3008 Location: Austin, TX 78751 - Onsite only (No remote work) The role involves delivering high‑quality products that meet the state’s operational and technical requirements. Responsibilities...ClaimsRemote work
- ...seeking an experienced Senior Business Analyst to support complex enterprise... ...cross‑functional teams to deliver high‑quality solutions. This role serves as a... ...transformation initiatives. Experience within Medicaid, Health & Human Services, Claims Processing, Eligibility Systems,...Claims
- ...Conduct in-depth financial analysis of claims trends, utilization patterns, and revenue... ...improvement. Analyze the financial impact of Quality Improvement (QI) initiatives and other... ...as needed. Assist with financial audits and regulatory reviews, providing...ClaimsWork at officeWork from home
- ...include conducting billing and coding audits, and communicating results and recommendations... ...compliance policies with government (Medicare & Medicaid) and private payer regulations.... ...used for coding and billing for medical claims. High Knowledge of medical terminology...ClaimsWork experience placementWork at office
- Senior Claims Integrity & Quality Analyst At Curative, we're challenging the status quo in healthcare by removing barriers to care and creating a health... ...-enabled claims organization. This is not a traditional audit role. You'll help design and execute the quality...ClaimsFull timeContract workRemote workFlexible hours
- ...seeking an experienced Senior Medicaid Data Architect to lead the... ...data management (MDM), data quality, metadata management, and enterprise... ...solutions supporting claims, encounters, provider, member... ...stakeholders, program leaders, analysts, and technical teams to align...Claims
- ...Description WHO WE'RE LOOKING FOR The Associate Counsel II reports directly to the Deputy Counsel. This position provides legal advice... ...Management Assess and advise on litigation risks related to claims, projects, contracts, and organizational initiatives. Oversee and...ClaimsFor contractorsWork at officeLocal area
$46.99k - $122.4k
...review of medical records. Activities include audits of provider records to ensure coding and... ..., recoupment of funds, rebilling of claims), and referral to state regulators for suspected... ...health plans that administer benefits to Medicaid members across multiple lines of business...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...accountability, inclusion, and continuous development. Job Scope The Quality Control Inspector II will be responsible for executing Quality Control... ...of department inspection methods, resolutions to address audit observation, non‑conformances, corrective actions, and...Work experience placementSecond jobLocal areaWorldwide
- ...leading restoration company in Austin is looking for a highly motivated Billing Specialist. The role involves preparing invoices, auditing documentation, and coordinating with clients and insurance carriers. The ideal candidate should have a high school diploma, excellent...Claims
$84k - $112k
...an exciting underwriting career opportunity as a PEO Underwriter II. This position is part of Aon's Underwriting Center of Excellence... ...plans for PEO clients. Analyze data such as census information, claims experience, and premium history to calculate insurance premiums....ClaimsFull timeTemporary workPart timeLocal areaShift work- ...Description Customer Service Representative, Medicaid Provider Support Location: Austin, TX... ...related to eligibility, medical claims, and program services. If you have recent... ...department when necessary. Meet established quality, productivity, attendance, and customer...ClaimsHourly payFull timeLocal areaRemote workShift work
$40.92k - $71.06k
...Position Transportation Maintenance Tech I/II/III – Amarillo EWay (2601289) Location Amarillo, Texas – Office 8401 S FM 1541, 79110... ...perform highly skilled roadway repairs; inspect and process damage claims; operate complex heavy equipment (motor grader, large excavator,...ClaimsFull timeWork at officeMonday to FridayFlexible hoursNight shiftWeekend workDay shift$37.31 - $58.75 per hour
...'s policies and procedures. Revenue Integrity Analyst II Service Areas: Emergency/Trauma, Transport, Behavioral... ...with charge, coding and charge edits. Audits and evaluates system automation by comparing the charge/claim data to the clinical record. Leverages other system...ClaimsHourly payMonday to FridayFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Quality Audit Analyst II - Medicare/Medicaid Claims. Be the first to apply!
- quality analyst Austin, TX
- quality improvement analyst Austin, TX
- remote call center quality analyst Austin, TX
- quality intern Austin, TX
- quality lead Austin, TX
- quality improvement nurse Austin, TX
- quality facilitator Austin, TX
- quality assurance quality control engineer Austin, TX
- quality improvement rn Austin, TX
- quality advocate Austin, TX


