Remote Claims QA & Audit Specialist
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- Remote job
Gallagher Bassett is seeking a senior claims auditor to ensure compliance across field offices, conduct client audits, and drive process improvements. The role involves training, performance monitoring, and collaboration with account management to meet client expectations. Strong licensing and liability experience are preferred. The position supports a remote work model with national scope, offering opportunities for professional growth and impact across diverse client engagements. #J-18808-Ljbffr Socket.dev
- Sarnova is seeking a QA Specialist to ensure accuracy and compliance of Medicare/Medicaid claims before submission. The role demands meticulous review of PCRs, coding validation... ..., and adherence to payer regulations, with remote work flexibility and strong emphasis on...Remote jobClaims
- ...Conducting audits of billing, documentation, insurance claims, and regulatory compliance activities, the full-time Audit Specialist will ensure adherence to Medicare, Medicaid, and commercial insurance requirements while identifying opportunities for improving reimbursement...Remote workClaimsFull time
- ...QVC Group is looking for a QA Performance Claims Specialist to review and approve product performance claims with technical substantiation. You will... ...accuracy and regulatory compliance. The role is remote for candidates in PA, NJ, DE, FL, NC, TN or VA, with a strong...Remote workClaims
- ...Quality Assurance Lead (QAL) In this hourly, remote contractor role, you will work as a... ...AI-generated Kannada content and trainer/QA work, evaluate output quality against project... ...phrasing, unnatural tone, hallucinated claims, ambiguity, or inconsistent terminology....Remote workClaimsHourly payFor contractors
- ...Quality Assurance Lead (QAL) In this hourly, remote contractor role, you will work as a... ...AI-generated Gujarati content and trainer/QA work, evaluate output quality against project... ...phrasing, unnatural tone, hallucinated claims, ambiguity, or inconsistent terminology....Remote workClaimsHourly payFor contractors
- ...seeks a detail-oriented Quality Assurance Specialist to support our physician review operations in a fully remote capacity. Review medical and claims-related documentation for accuracy,... ...bachelor's preferred) and 1-3 years in QA or claims review. Strong attention to detail...Remote workClaims
- ...A leading medical claims company based in the United States is seeking a Clinical Reviewer to evaluate and ensure the accuracy of medical billing and coding. Ideal candidates will have a CPC, APCC, CMBS, or DRG certification and previous experience in a medical office...Remote workClaimsExtra incomeWork at officeFlexible hours
- QVC Group, Inc. is seeking a QA Performance Claims Specialist to evaluate and determine approval of product performance claims with technical expertise. This remote role requires residency in PA, NJ, DE, FL, NC, TN or VA, and offers total rewards including benefits from...Remote jobClaimsFixed term contract
- ...Auditor to join our healthcare administration team in Richardson, TX. The role focuses on pre-claim review, auditing medical records, and ensuring accurate billing through QA processes. You will work with Billing and Compliance teams, monitor billed and unbilled accounts...Claims
- ...processes, the full-time RCM Audit Specialist will conduct audits, monitor... ...with various RCM leaders in a remote work environment. Key responsibilities... ...and audit revenue cycle claims against established standard... ...of experience in an auditing/QA role or equivalent RCM-...Remote workClaimsFull time
$24 - $28 per hour
...Quality Audit Specialist Remote - Tustin, CA Make an Impact Through Accuracy, Analysis, and Continuous Improvement Are you a detail-oriented claims professional who thrives on identifying trends, ensuring compliance, and improving operational quality? Join Liberty...Remote workClaimsHourly payWork experience placementImmediate startRelocationVisa sponsorshipFlexible hours$70k - $78k
...Nationwide consideration for an Underwriting Audit Specialist. Summary Responsible for performing... ...that provides flexibility to work remotely while maintaining meaningful in-office... ...America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company...Remote workClaimsWork experience placementWork at office- ...when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness... ...client. Serves as an additional level of QA and clinical knowledge/review for cases... ...is a plus. ● Experience working in a remote environment is preferred. ● Experience in...Remote jobClaimsExtra incomeWork at office
$84k - $112k
...contributes to that mission - and as Clinical Audit Response Specialist, you’ll help protect reimbursement... .... Experience with payer audits, claims appeals, DME, medical device, oncology... ...and based in Portsmouth, NH. Hybrid or remote work expectations may vary based on business...Remote workClaimsFull timeWork at officeLocal area- ...benefits package. EOE SUMMARY: The Audit Specialist is responsible for conducting audits of billing, documentation, insurance claims, medical records, and regulatory... ...Primarily office-based with opportunities for remote work depending on department policy. Frequent...Remote workClaimsFull timeFor contractorsWork at officeLocal area
- ...To ensure the integrity of internal controls, the full-time remote Quality Assurance Specialist III will conduct in-depth audits of claims processes, identify transaction errors, and provide coaching and feedback for improvement. Key responsibilities Perform regular...Remote workClaimsFull timeContract workWork at office
- Job Type: Contract, Part-time Location: Remote Role Description In this hourly, remote contractor... ...in logic, messaging, audience targeting, claims/compliance risk, structure, and style;... ...with AI data training/annotation, content QA, editorial operations, or style‑guide...Remote jobClaimsHourly payContract workPart timeFor contractorsImmediate start
$45k - $51k
...Quality Assurance Specialist Cobalt Benefits Group is seeking a detail-oriented Quality Assurance Specialist to support our healthcare vertical clients through comprehensive claims auditing and quality oversight. This role is primarily responsible for conducting daily...Remote workClaimsDaily paidFull timeContract workTemporary workSummer workWork at officeFlexible hours- Manager, Post-Pay Audit Job Summary: We are seeking a detail-oriented and driven... ...candidate has experience in medical claims auditing, strong leadership capabilities,... ...supervisory or team lead role , preferably with remote or offshore team management experience....Remote workClaims
$47.66k - $87.38k
PURPOSE The Quality Specialist II is responsible for examining and evaluating the accuracy of transactions in accordance... ...participates in projects. ESSENTIAL FUNCTIONS Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation...Remote jobClaimsContract workWork experience placementWork at officeImmediate start$70k - $80k
Quality Assurance Specialist Are you passionate about pets? Do you have... ..., packaging, labels, claims, manuals, artwork, and supporting... ...supplier records to support audits, registrations, customer requirements... ...in office and one (1) day remote per week. Additional remote...Remote workClaimsWork at office1 day per week- ...Audit ManagerTrueScripts Management Services is a pharmacist-founded, fully transparent... ...Manager partners closely with Operations, Claims, Client Services, Clinical, IT, Security,... ...deadlines.Work Environment:This role is a remote job with a flexible "8-5" 40 to 45-hour...Remote workClaimsFlexible hours
- ...Revenue Cycle Quality Assurance Specialist to join our complianceteam.... ...checkon the revenue cycle — auditing billing, coding, accounts receivable... ...our Terrell, TX office, with remote work available in... ...requirements Auditacross the full claim lifecycle, including patient...Remote workClaimsTemporary workWork at office
$27.85 - $33.5 per hour
...0 Hourly Primary Purpose: The QA Associate - Technical & Regulatory... ...documentation, and supporting audits and compliance initiatives.... ..., labeling, and product claims Prepare documentation and support... ...arrangement ensures that all remote work is conducted from one of...Remote workClaimsHourly payFull timeWork at officeWork visaMonday to Friday$73k - $145k
...Reporting to the Director of Internal Audit, the Internal Audit Manager will serve as... ...advisory value as Devoted scales. This is a remote, U.S.-based builder role for someone who... ...Medicare / Medicare Advantage, CMS compliance, claims, revenue cycle, care delivery, or...Remote workClaimsFull timeContract workInternshipShift work- ...Fact-Check Workflow Research QA Specialist is a remote review track for evaluating AI outputs across... ...derivations, calculations, or experimental claims. Flag dimensional, methodological,... ...reviewers using textbook methods. Audit a 25-row batch for rubric consistency...Remote jobClaimsHourly payFor contractors10 hours per week
- ...Experience conducting constructability and design reviews. Knowledge of contract administration processes, including change orders and claims review. Required Education Bachelor's degree in Engineering, Architecture, Construction Management, or related field. USACE QCM...Remote workClaimsContract workTemporary workFor contractorsWork at officeImmediate startFlexible hours
$102.2k - $114.2k
...Underwriting Audit Supervisor Philadelphia Insurance Companies, a member of the Tokio... ...model that provides flexibility to work remotely while maintaining meaningful in-office collaboration... ...America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company...Remote workClaimsWork at office$102.2k - $114.2k
...Nationwide consideration for an Underwriting Audit Supervisor. Summary The Underwriting... ...model that provides flexibility to work remotely while maintaining meaningful in-office collaboration... ...America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company...Remote workClaimsWork at office$167.6k - $274.5k
Group Audit (GA) is an international team of 250 colleagues from 33 different nationalities... ...in office and allowing two days working remotely. As a Senior Audit Manager your main... ...casualty insurance topics i.e. underwriting, claims, product, reinsurance, in line with...Remote workClaimsFull timeTemporary workApprenticeshipWork experience placementWork at officeLocal areaVisa sponsorshipFlexible hours
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