Claims Configuration & Audit Analyst - Office365
Healthfirst
Healthfirst is seeking a Configuration Analyst of Office365 to manage Office365 global tenants and governance, supporting collaboration across SharePoint Online, MS Teams, OneDrive, and related apps. The role emphasizes effective communication, vendor interface, and governance adherence while aligning with enterprise-wide configuration standards. The candidate will perform audits, interpret provider contracts for claims testing, and collaborate with business units to ensure accurate, compliant #J-18808-Ljbffr Healthfirst
$118.69k - $189.91k
...Principal Actuarial Data Systems Analyst, you will play a crucial... ...data is appropriately auditable, snapshotted, and stored for... ...implementation. Provide detailed configuration expertise to customers and... ...' experience with medical claims, Pharmacy/medical rebate data...ClaimsWork at officeLocal areaRemote workFlexible hours2 days per week- ...Senior Analyst/Associate Revenue Cycle Management - Due Diligence, Advisory & Implementation... .... Ingest, normalize, and analyze claims, charges, payments, adjustments, denials... .../PM platforms, including workflow and configuration requirements, build validation, testing...ClaimsWork at officeLocal areaRemote work
$40 - $50 per hour
...role focuses on performing Medicare and Medicaid reimbursement audits and reviewing hospital and provider cost reports to ensure that... ...reimbursement compliance. Understanding of revenue cycle processes and claims processing in healthcare settings. Job Type & Location This is a...ClaimsContract workTemporary workRemote work- ...seeking a Trade Promotion Management (TPM) Analyst to support the implementation,... ...Responsibilities Support the implementation, configuration, testing, and rollout of Salesforce... ...management, customer business planning, and claims management. Partner with Sales, Finance...ClaimsContract work
- R1 RCM, Inc. is seeking a DRG Associate Auditor (Analyst) to validate coding updates that can affect the diagnosis-related group on a claim and result in additional reimbursement or coding compliance and education for the client. Must have four+ years of ICD-10 coding...Claims
$62k - $100k
...through innovation has been a core part of our DNA across our audit, tax, and consulting groups. That’s why we continuously invest... ...based on client needs and project scope. Support the design, configuration, prototyping, testing, and implementation of GRC, compliance,...Full timeLocal areaWorldwide- ...Position Overview: Serve as the main point of contact for the Claims Processing workstream. In partnership with our Consultant, interview... ...and objectives. This includes, but is not limited to, system configuration, workflows, reporting, and capacity plans. Create an inventory...ClaimsContract workMonday to FridayShift work
$26 - $28.5 per hour
Immediate need for a talented Quality Review and Audit Analyst . This is a 03+ months contract opportunity with long-term potential and is... ...and have excellent organization skills Understanding of medical claims submissions is preferred Ability to meet timeline,...ClaimsContract workLocal areaImmediate startRemote work- This Quality Assurance Analyst will be responsible for reviewing the Claims Processing Systems for configured benefits and reimbursement methodologies. Experienced candidates must demonstrate working understanding of claims processing systems and working knowledge of the...ClaimsContract workRemote work
$42 - $51 per hour
...team of Risk Adjustment Campaign Associates are living our mission to make health care easier and lives better. As a member of the Claims Audit/Risk Adjustment team, our Risk Adjustment Campaign Associate works with the Risk Adjustment operations team on on-going...ClaimsHourly payTemporary workWork at officeWork from homeFlexible hours$76.7k - $142.5k
...transformative change.About the Role - Business Analyst AdvisorRemote, NYJob... ...functional and technical needs.· Solumina Configuration — Configure modules such as Work Instructions... ...websites, or through unsolicited emails claiming to be from the company. These emails may...ClaimsMinimum wageFull timeContract workRemote workFlexible hours$69.4k - $95k
...) to receive an alert: Senior Business Analyst Date: Oct 22, 2026 Location: Any city,... ...of computer programming concepts such as configuration, development, batch processing, and data... ...Familiarity with healthcare, Medicaid, Medicare, claims, eligibility, or other highly regulated...ClaimsFull timeRemote workFlexible hours- # Data Analyst, Clinical Data EffectivenessClover HealthRemote Full Time Remote Posted 4... ...across disparate sources like structured claims, clinical care summaries (CCDAs), and... ...the implementation of optimal technical configurations for existing data vendors (e.g., Bamboo...ClaimsFull timeWork at officeRemote workFlexible hours
- ...driven program that speeds up return-to-work and generative AI for claims management, we're redefining what workers' comp can do. We’... .... Maintain complete model documentation so any model can be audited or handed off without your direct involvement What We're Looking...ClaimsRemote work
- Job Title: Senior Oracle EPM Analyst A market-leading organization is seeking a Senior... ...4 years of experience with Oracle PBCS Configuration and integration experience Knowledge of... ...type: Full-time Job function: Accounting/Auditing, Consulting, and Finance Industry:...Full time
$150k - $180k
...S. You will work closely with Underwriting, Product Management, Claims, Finance, Risk Management, Distribution, and actuarial/product colleagues... ...in accordance with Aviva Standards. Support regulatory reviews, audits, and actuarial certifications as required. Maintain strong...ClaimsWork at officeRemote workFlexible hours$100k - $150k
...world.Position SummaryThe Senior Actuarial Analyst is responsible for conducting and... ...reporting, and collaborating with Finance, Claims, Underwriting, and ERM. The position requires... ...including detailed rationale for management and audit review.Independently analyze loss...Claims- ...Position Overview Delos is seeking an Actuarial Analyst to support pricing and portfolio... ...policy, premium, exposure, and available claims data. Investigate discrepancies and document... ..., SUMIFS/VLOOKUP, charts, and formula auditing. Ability to work with large datasets, identify...ClaimsInternship
- ...application process. Sr. Healthcare Business Analyst/Quality Engineering Shared Services Full... .... Analyze workflows and data across claims, benefits, eligibility, enrollment,... ...sign-off; distinguish requirement gaps, configuration issues, data-quality problems, workflow...ClaimsFull timeWork at officeLocal areaRemote work
$166.9k - $278.1k
...Enterprise Management, Risk Management, Compliance Management, Audit Management, Regulatory Change Management), Third-party Risk... ...roles required Expertise with Archer form and layout design configuration, development of field updates, advanced workflow, troubleshooting...$55 - $60 per hour
...NetworX Configuration Analyst Max SBR: $55-60/hr on w2 Remote Must Haves: Pricer and NetworX Modeler experience. 2. Provider contract... ...and network reimbursement. 3. FACETS configuration and claims adjudication knowledge. Job Summary We are seeking a...ClaimsHourly payContract workRemote work$75.35k - $98.89k
...Job Description Hi, we're Oscar. We're hiring a Senior Analyst to join our Claims and Benefits Team. Oscar is the first health insurance... ...in the family. About the role: The Senior Analyst, Configuration supports the business by improving the consistency, accuracy...ClaimsFull timeContract workWork at officeFlexible hours- ...Jobs Workday Financial Systems Analyst Join Aspire's Finance... ...financial systems with HR, payroll, claims, or policy administration... ...Accounting Center Support the design, configuration, testing, and implementation... ...activities within Workday. Audit, Compliance & Data Governance...ClaimsLocal area
$132k - $181.5k
...innovation through technology.The Staff Product Analyst OpportunityReporting to the Director -... ...will drive the functional architecture, configuration, and continuous optimization of key... ....Establish robust system controls, audit trails, and data governance standards for...Work experience placementLocal areaWorldwideFlexible hours$28 - $33 per hour
...Location: New York, NY (Preferred) / Hybrid Reports to: Claims Supervisor Covet Health is a modern, API-first TPA and benefits... ...of business. Additionally, this involves identifying system configuration discrepancies, maintaining benefit code update tracking, and...ClaimsPermanent employmentFull timeWork experience placementWork at officeMonday to Friday$86.97k - $130.46k
...expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human... ...JOB SUMMARYThe Senior Payroll Analyst is accountable for the accurate... ..., manages payroll-impacting configurations and change controls, and drives...ClaimsFull timeLocal areaRemote workVisa sponsorship$140k - $180k
...Senior Audit Program Manager, Security Assurance Houston; New York; San Francisco;... ...management, GPU/compute infrastructure configuration, change management, logging, vulnerability... ...assess whether the evidence supports its claimed design and operation. ~ Experience...ClaimsFlexible hours- ...Manage the complete medical billing cycle from coding and claim submission through payment posting, denial resolution and collections... ...denied claims Manage outstanding balances Support billing accuracy audits What we're looking for Three or more years of medical billing...ClaimsFull timeRemote work
- ...Job Description Job Title: Senior Healthcare Business Analyst / Behavioral Health SME Experience: 10 Years Domain: Healthcare... ...payer lifecycle: Eligibility & Enrollment Benefits Configuration Claims Processing & Adjudication Prior Authorization Care &...Claims
- ...ll grow. This is an excellent opportunity for an experienced claims or insurance professional to gain diversity in your career across... ...priorities and high pressure. Conduct technical work product audits and targeted reviews to analyze data trends that affect claim...ClaimsShift work
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