Senior Medicaid Program Integrity & Claims Auditor
$120k - $140kBerryDunn
BerryDunn is hiring a Senior Consultant focused on Medicaid program integrity and claims audits. The ideal candidate will provide assistance on risk assessments and compliance, conduct audits, and develop corrective action plans. This position allows for remote, hybrid, or on-site work. Preferred qualifications include consulting experience and relevant certifications. The salary range is $120,000 - $140,000, and benefits support employee well-being and growth. #J-18808-Ljbffr
$120k - $140k
...BerryDunn is seeking a Senior Consultant with expertise in Medicaid program integrity and claims audits. The role involves assisting clients in detecting fraud and conducting audits while ensuring compliance with federal regulations. Remote, hybrid, or office work is available...SeniorClaimsWork at officeRemote work$46.99k - $122.4k
...community at a time. Position Summary The Program Integrity Auditor is responsible for the review of... ..., recoupment of funds or rebilling of claims, and referral to state regulators for... ...that currently administers benefits to Medicaid members across multiple lines of business...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...The Hispanic Alliance for Career Enhancement is hiring a Program Integrity Auditor in New York, NY. This full-time position involves auditing medical... .... Ideal candidates will have 3-5 years of experience in claims data review, industry coding guidelines, and hold a valid...ClaimsFull time
$46.99k - $122.4k
Hispanic Alliance for Career Enhancement in Georgia is hiring a Program Integrity Auditor responsible for auditing healthcare records. This role requires 3-5 years of experience in claims data review and medical coding standards (CPT, HCPCS, ICD-10). Candidates should hold...Claims$46.99k - $122.4k
The Hispanic Alliance for Career Enhancement is seeking a Program Integrity Auditor based in New Jersey. This role involves auditing medical records... .... The ideal candidate will have 3-5 years of experience in claims data interpretation and hold certifications such as CPC or...ClaimsFull time- ...A health insurance company is seeking a Senior Specialist, Coding Auditor to join their Payment Integrity team. This remote position involves supporting issue resolution, ensuring claims repayment quality, and assisting in root cause analysis. Candidates should have 1...SeniorClaimsRemote work
$120k - $140k
...Overview BerryDunn is seeking a Senior Consultant with subject matter expertise in Medicaid program integrity and claims audits to assist clients with prevention and detection... ...equivalent Certified Professional Medical Auditor (CPMA) or equivalent. Certified Internal Auditor...ClaimsRemote work$93.2k - $147k
...EHP), which consolidates all claim administration-related... ...Summary The Pharmacy Value Programs Senior Project Manager will lead the... ...Commercial, Exchange, Medicare, and Medicaid. In this highly... ...benefit design optimization, and integration with manufacturer direct offerings...SeniorClaimsWork at officeLocal areaRemote workFlexible hours$46.1 - $53.1 per hour
...Overview The Sr. Auditor, Quality Assurance position is responsible for ensuring that the audited claims meet quality standards necessary to generate high quality recoverable... ...is supported and as accurate as possible. Integrates healthcare auditing principles and uses...SeniorClaimsHourly payWork at officeImmediate startFlexible hours- ...Second Nature is seeking a Sr. Manager of Insurance Program to lead insurance operations for the organization. This role involves managing teams, overseeing claims processes, and ensuring operational excellence. The ideal candidate has over 5 years of experience in insurance...SeniorClaimsRemote work
- ...A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...ClaimsRemote work
- ...Independence Blue Cross is seeking an Auditor, Payment Integrity to conduct pharmacy claim audits ensuring accurate provider payments while detecting fraud and improving audit processes. This fully remote role requires a Certified Pharmacy Technician with at least...ClaimsWork at officeRemote work
$67.9k - $182.55k
...Position Overview The Senior Manager, Medical and Payment Policy... ...The role partners closely with claims operations to apply policy... ...relations – to ensure seamless integration of claims coding changes and... ...commission or short‑term incentive program in addition to the base pay...SeniorClaimsHourly payFull timeTemporary workLocal area$211.55k - $317.33k
...leading healthcare technology firm in the United States is seeking a Senior Medical Director. This pivotal role involves providing... ...and improvement of pre-payment edits to ensure robust payment integrity. Candidates must be board-certified physicians with at least 10...SeniorClaims$65 - $75 per hour
...Transcarent is looking for a Senior Product Manager to own the product... ...and roadmap for our data integration platform that powers the... ..., governing how eligibility, claims, pharmacy, and other enterprise... ...eligible for the corporate bonus program or a sales incentive (target...SeniorClaimsContract workRemote workFlexible hours$211.55k - $317.33k
...A leading healthcare technology firm seeks a Senior Medical Director to provide strategic oversight for pre-payment edits and improve payment integrity. The role involves collaboration with executive leadership and various stakeholders, ensuring innovative healthcare...SeniorClaimsRemote work$100k - $125k
...as a top affordable housing, seniors housing, and small balance loan... ...of our culture of caring, integrity and excellence and is a driving... ...for a Senior Internal Auditor who will report to the Director... ...you are contacted by someone claiming to represent Greystone and suspect...SeniorClaimsWork at officeFlexible hours$150k - $160k
...and auditable environmental claims to address the growing global... ...Summary Xpansivis seeking a Senior Project Manager to leadhigh impact... .... Maintain and manage integrated project schedules, milestones... ...services, energy, or environmental programs. What can you expect...SeniorClaimsLocal areaWorldwide- ...Port Authority of NY & NJ The Senior Cloud Architect & Program Manager is a senior technical... ...leadership on Azure migrations, hybrid cloud integrations, and DevOps enablement. Program &... ...accommodation (1) if they claim a disability is affecting the interview...SeniorClaimsRemote work1 day per week
$95k - $130k
...Senior Internal Auditor page is loaded## Senior Internal Auditorremote type: Hybridlocations: NJ-Warrentime... ...contribution* Wellness incentive program* Life and accidental death and... ...insurance products, risk engineering and claims management services that enable our clients...SeniorClaimsTemporary workWork experience placementLocal areaFlexible hours$211.55k - $317.33k
...Color Employer, LLC is seeking a Senior Medical Director to provide clinical leadership and oversee the development of payment integrity strategies. This role involves collaborating with executive leadership, clinical teams, and external stakeholders, ensuring that Lyric...SeniorClaimsFull time$68.8k - $94k
...LE10 Public Consulting Group LLC (Education) is seeking a TPA Claiming Lead responsible for directing claims management within the School... ...has 6+ years of claiming experience and strong knowledge of Medicaid policies. Compensation ranges from $68,800 to $94,000, with benefits...SeniorClaimsRemote work$140k - $180k
...are JUST GETTING STARTED. Job Title: Senior Technical Program Manager – Insurance Systems Location:... ...architecture and data flows to anticipate integration challenges and guide resolution.... ...decisions. Collaborate with underwriting, claims, and support teams to ensure...SeniorClaimsTemporary workRemote workFlexible hours- ...is a rare opportunity for a senior technology leader to help run... ...assumptions, validate delivery claims, and step in when quality,... ...of funds to protect delivery integrity and public investment Coordinate... ...resolution, and overall program success The Leader We’re Looking...SeniorClaimsFull timeRemote workMonday to Friday
$145k - $200k
...Mathematica Inc. is looking for a Senior or Principal Researcher with extensive experience in Medicaid and CHIP programs. The role demands a deep understanding of health policy and proven leadership in project development. The successful candidate will oversee multidisciplinary...Senior$110k - $130k
...obsession. About The Role Second Nature is seeking a senior, strategic leader to take ownership of our Insurance Program as Sr. Manager of Insurance Program. In this... ...package — managing direct reports, overseeing claims operations, and building scalable processes that...SeniorClaimsRemote work- ...Cotiviti, Inc. is seeking a full-time State Licensed Senior Auditor to support the Clinical Chart Validation team. In this remote role, you will defend recovery determinations by reviewing claims and applying relevant guidelines. The ideal candidate will possess an Associates...SeniorClaimsFull timeRemote work
$160k - $185k
...healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one... ...'s platform. You will sit at the intersection of complex data integrations, sensitive member data, and the engagement tools and campaigns...SeniorClaimsPermanent employmentFull timeContract workH1bWork at officeImmediate startRemote workWork visaFlexible hours3 days per week$120k - $135k
Judi Health is seeking a Senior Manager for Government Programs Operations in New York to lead the implementation and oversight of regulatory requirements... ...commitments. A strong candidate will have experience in claims operations and the ability to manage operational...SeniorClaimsRemote job$51.8k - $75k
...RSC Insurance Brokerage, Inc. is seeking a detail-oriented Audit Specialist to conduct thorough audits of claims files, ensuring compliance and accuracy. The ideal candidate will have 4–6 years of claims or audit experience, a bachelor's degree preferred, and strong analytical...SeniorClaims
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