Claims Auditor
Berkley Accident and Health (a Berkley Company)
Berkley Accident and Health is seeking a Stop Loss Claims Auditor to perform quality review of medical claims submissions and determine eligibility for reimbursement. This role offers a hybrid/remote setup with multiple office options in the Northeast and beyond.
The ideal candidate has 3–5+ years of stop loss claims experience, familiarity with CPT/revenue codes, and strong analytical abilities. A competitive benefits package accompanies the position.
#J-18808-LjbffrVacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Claims Auditor in United States vacancy
- ...HealthPosted: 2026-08-19Elevance Health is seeking a DRG Coding Auditor to ensure accuracy in MS-DRG and APR-DRG classifications across... ...expertise to audit and generate high-quality recoverable claims for the company and its clients.The position offers hybrid/virtual...ClaimsRemote work
- ...HealthPosted: 2026-08-20Elevance Health is seeking a DRG Coding Auditor to review inpatient records and ensure accurate DRG assignments... ...this role.The position emphasizes high-quality recoverable claims across lines of business, using audit tools and established guidelines...ClaimsRemote work
- ...services company is seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider... ...such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and...ClaimsWork at officeRemote workFlexible hours
- ...must, auditing experience is preferred. seeking a certified professional coder with significant experience in coding professional claims in a medical office-based setting. Experience with coding different specialties is preferred. Looking for a candidate who has interacted...ClaimsPermanent employmentWork at office
- ...make an impactJob Summary:Responsible for leading complex pharmacy claim audits, ensuring compliance with client-specific requirements,... ...comprehensive reports with actionable recommendations. The Auditor provides strategic insights through advanced data analysis, predictive...ClaimsLocal area
$40.3k - $80.8k
...ensuring every individual has the opportunity to succeed and make a difference. Position Summary: Under supervision, investigates claims liability and determine the extent of liability on a submitted claim for a specific individual. Accurately processes the claim...ClaimsFull timeWork experience placementCasual workWork at officeLocal areaRemote workFlexible hours- Stance Health Solutions is seeking a Revenue Cycle Auditor to manage the revenue cycle, submit and follow up on insurance claims, and resolve payer discrepancies. The role involves analyzing accounts receivable, identifying denial patterns, and coordinating with providers...Claims
- OverviewCDI Auditor & EducatorFull Time, 80 Hours Per Pay Period, Day ShiftCovenant Health Overview:Covenant Health is the region’s top... .... Reviews third- party payers guidelines to ensure accurate claims charging, coding, and billing. Communicate audit results through...Claims
- Overview The Healthcare Delivery Auditor supports Central Health’s mission to provide access to high-quality care for underserved populations... ...documentation supports medical necessity, aligns with billing claims, and meets regulatory and policy standards (e.g., HIPAA, CMS,...ClaimsFull timeLocal area
- ...Convey Health Solutions, located in Overland Park, Kansas, is seeking an Auditor for the Benefit Administration Program. This role is vital for ensuring compliance in the rapidly evolving healthcare environment, focusing on internal audits related to the Over the Counter...Claims
Convey Health Solutions
Overland Park, KS5 days ago - ...United StatesCompany: Integrated ResourcesPosted: 2026-08-20Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a... ...discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels. • Identifies error...ClaimsDaily paidFull timeContract workWork at office
- ...per week) Desired Skill Set:The ideal candidate is an healthcare auditor with a minimum of 7 years auditing experience MINIMUM... ...g., coding assignments, charge capture, clinical documentation, claim submissions, etc.) from planning through completion. Develops methods...ClaimsFull timeWork at office1 day per week
$92.88k - $160.22k
...- $160,218Company: Elevance HealthPosted: 2026-08-19DRG Coding Auditor - MS-DRG and APR-DRGVirtual: This role enables associates to work... ...medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and...ClaimsFull timeTemporary workWork experience placementLocal area1 day per week- ...Personify Health is seeking a Senior Configuration Quality Audit Analyst to oversee end-to-end audits of complex claims configurations, ensuring accuracy against client requirements, contracts, and regulatory guidelines. You will translate SPDs and contracts into precise...Claims
Personify Health
Brooklyn, NY5 days ago $61.61k - $94.24k
...maintaining managed care health plan delegated auditing functions, including but not limited to, review of pre and post payment of claims, documenting errors assigned, reporting of claims processing errors and providing feedback to ensure compliance with all health plans...ClaimsMinimum wageFull timeLocal areaShift work$71.32k - $112.84k
...Job Description : GENERAL OVERVIEW: Senior most coding auditor who evaluates medical records to determine the accuracy of coding... ...billing and documentation related to DRG, OPPS and outpatient claims. Reports findings both verbally and in writing and communicates...ClaimsFull timeFor contractorsLocal area$71.32k - $112.84k
...Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics.... ...corrective actions when needed. Advises UR/CM in defending payor claims denials for medical necessity, coding, billing and documentation...ClaimsFull timeFor contractorsWork at officeLocal area- ...Brown & Brown, Inc. (NYSE: BRO) is seeking a detail-oriented analyst to analyze aggregate stop loss and accommodation claims. You will validate eligible expenses under the contract, perform enrollment calculations to ensure correct attachment, and produce audit deliverables...ClaimsContract work
Risk Strategies
New York, NY3 days ago $116.13k - $210.86k
...for employment, unless accommodation is granted as required by law.Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating...ClaimsDaily paidFull timeTemporary workWork experience placementWork at officeLocal area1 day per week- ...Relation Insurance, Inc. in Tulsa, OK, is seeking a Claims Auditor to perform operational and quality audits of claims processing. You will review files, document findings, and prepare audit reports, identifying trends and opportunities for improvement. The role requires...Claims
Relation Insurance Inc
Tulsa, OK1 day ago - Jobtailor is seeking a Health Insurance Claims Auditor to conduct pre- and post-pay audits for Medicare/Medicaid, ensuring CMS compliance and high-quality processing. You will collaborate with delegated processors to correct errors before payments and support ad-hoc audits...ClaimsWork at office
- ...Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for accuracy in billing, pricing and adjudication. The role supports the Quality Department and collaborates with internal and external stakeholders to ensure proper reimbursement...Claims
Brighton Health Plan Solutions
Chapel Hill, NC5 days ago $46.99k - $122.4k
...for Career Enhancement in Virginia is hiring a Program Integrity Auditor to review medical, behavioral, and transportation records... ...coding standards. The role requires 3-5 years of experience with claims data interpretation, a CPC/CCS/CPMA license, and preferred familiarity...ClaimsFull timeHispanic Alliance for Career Enhancement
Virginia, MN1 day ago$30.5k - $42.5k
A leading healthcare solutions provider is looking for a Medical Claims Auditor to work remotely from Texas. The ideal candidate will review and analyze medical claims for accuracy and compliance, validate coding, and identify errors. With at least three years of relevant...ClaimsRemote workGainwell Technologies
Wausau, WI2 days ago$25 - $30 per hour
...Date Open Date 08/10/2026 Closing Date 08/21/2026 Silver Creek Central School District 2026-2027 Vacancy Announcement Internal Claims Auditor - Part time Position Location: Silver Creek Central Business Office Minimum Qualifications: Associates Degree in Accounting or...ClaimsHourly payPart timeWork at officeSilver Creek CSD
Friendswood, TX4 days ago$53.2k - $80k
...fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and... ...Denver or Charlotte areas) Position Summary The Pharmacy Auditor is responsible for conducting comprehensive audits of network...ClaimsFull timeWork at officeLocal areaRemote workFlexible hours- ...Elevance Health is seeking a DRG Coding Auditor Principal to support virtual, full-time work with occasional in-person training. Roles... ...audit processes and recoveries. The candidate will analyze complex claims using ICD-10 guidelines and DRG concepts, produce audit...ClaimsFull timeWork at office
Elevance Health (Anthem)
Mason, OH1 day ago - ...Evolution Risk Partners, LLC is looking for a Stop Loss Claims Auditor or Senior Stop Loss Claims Auditor in Evanston, Illinois. The role involves auditing and authorizing reimbursements for medical claims while ensuring exceptional customer service. The ideal candidate...Claims
Evolution Risk Partners LLC
Evanston, IL5 days ago - ...PAE Government Services Inc. in Omaha, NE seeks an experienced auditor to support investigations into federal fraud and compliance matters, including the False Claims Act and related statutes. You will analyze complex data sets, identify outliers, and prepare clear reports...Claims
PAE Government Services Inc.
Omaha, NE5 days ago - A leading healthcare company is seeking an Inpatient Medical Coding Auditor to join their team remotely. The role involves reviewing inpatient hospital claims for proper reimbursement, analyzing medical data, and ensuring accuracy in coding. Candidates should have relevant...ClaimsRemote work
Humana
United States3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Auditor. Be the first to apply!
Related searches