Senior Healthcare Claims Quality Auditor (Remote)
VALID8 Financial
Valid8 Financial, Inc. is looking for a Senior Auditor for Healthcare Claims to oversee claims quality and compliance. The role requires strong expertise in auditing processes and collaboration across multiple teams. This remote position supports operational excellence through analysis and audits of various healthcare claims. The ideal candidate should have a Bachelor’s degree in Healthcare Administration, at least 7 years of relevant experience, and strong analytical skills to drive improvements in claims management and regulatory compliance. #J-18808-Ljbffr
- ...A healthcare management organization is seeking a Quality Control Auditor – Claims Management in California. This role is responsible for auditing claims processing activities to ensure compliance and accuracy. With over five years of experience in managed care claims...SeniorClaims
$25.38 - $36.76 per hour
...in California is seeking a Quality Auditor to perform operational audits... ...health plan operations including Claims and Enrollment.... ...has 3+ years of experience in healthcare audit processing, strong analytical... ...38 to $36.76 per hour and a remote work option. #J-18808-Ljbffr...Remote workClaimsHourly payWork at office$35 per hour
...Study Skills Research Institute is seeking a Quality Assurance III to ensure the proper... ...adjustment coding and involves reviewing provider claims to maintain operational standards.... ...and over 3 years of relevant experience. Remote work is possible, with hourly compensation...Remote workSeniorClaimsHourly pay- ...Hennepin Healthcare is seeking a patient-focused individual for a revenue cycle role. This position... ...information and assisting with complex claim issues while providing outstanding... ...communication skills. The role offers a remote work option and supports a diverse and equitable...Remote workSeniorClaims
$30 - $40 per hour
...HealthCare Resolution Services, Inc. is seeking a Claims Auditor located in Columbia, Maryland. In this role, you will be responsible for auditing medical and dental claims, ensuring accuracy and compliance with internal policies. The ideal candidate holds a Bachelor'...Remote workClaimsHourly pay$28 - $33 per hour
...A healthcare solutions provider is seeking a Coding Specialist III to manage up to two short... ...and procedures for inpatient hospital claims and validating MS-DRG and APC calculations... ...wage between $28.00 and $33.00, with flexibility for remote work. #J-18808-Ljbffr...Remote workSeniorClaimsHourly payTemporary work- ...expertise in coding, documentation review, and claims filing. The role involves working with... ...guidelines and collaborating with healthcare professionals. Qualifications include a... ...Radiation oncology experience. The role offers remote work options post-training, with...Remote workClaims
- ...Our client is seeking a Coding Auditor responsible for conducting... ...Review charge information, claim forms, insurance correspondence... ...professionally with all levels of the healthcare team. Proficiency with... ...Requirements This is a REMOTE role but requires on-site...Remote workClaimsTemporary workWork at officeLocal area
- ...nLeague is hiring for a Manual Testing position in Richmond, VA, requiring 3 days onsite and 2 days remote. Candidates with in-depth Healthcare Claims expertise and testing leadership skills are preferred. The role focuses on manual testing and includes performing complex...Remote workSeniorClaims
- ...Gallagher Bassett is seeking a Senior Claims Specialist based in Houston, Texas. This role focuses on managing complex Healthcare Professional Liability claims and requires a Bachelor... ...experience. The position is fully remote, allowing for flexibility while ensuring...Remote workSeniorClaims
- 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...Remote jobSeniorClaims
$110k - $150k
Remote Jobs is looking for an Insurance Claims Specialist to manage healthcare-related claims. The ideal candidate will have a valid P&C Brokers' license or adjuster license, along with 7-10 years of experience in the field. Responsibilities include researching policy...Remote workSeniorClaims$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... ...strong analytical skills, and proven leadership. This remote position offers a competitive salary range of $211,551...Remote workSeniorClaims$80k - $84k
...TriWest Healthcare Alliance in Phoenix, AZ offers a remote opportunity for a medical claims reviewer. This position involves conducting retrospective medical claims reviews and ensuring proper coding for inpatient and outpatient services. Ideal candidates will have relevant...Remote workSeniorClaims- ...Gainwell Technologies is seeking a Sr. Technical Lead - C/Unix Batch Development focused on healthcare claims solutions. This remote role requires leading a technical team to improve client health outcomes with technology. Applicants should have extensive experience in...Remote workSeniorClaimsFlexible hours
- ...A healthcare technology firm in Boston is seeking a Quality Assurance Specialist to perform inpatient DRG validation audits. The role requires at least 5 years of experience in reviewing ICD-10 claims and an understanding of coding standards. Responsibilities include...Remote workSeniorClaimsFull time
- A healthcare organization is seeking a detail-driven Sr. Internal Auditor to enhance compliance and service quality within the dental benefits sector. The successful... ...candidate will analyze claims data, ensure accurate... ...work environment with remote options and competitive...Remote workSeniorClaims
- ...Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: The Claims... ...or equivalent At least 3-5 years of Quality Analyst in healthcare, TPA, or health plan settings/ healthcare claims or in a...Remote workClaimsFull time
- ...Payfuture Technologies is looking for a Senior Programmer to manage healthcare claims and EMR databases. The role requires strong SAS and Python programming... ...communication and documentation skills are essential for success in this remote position. #J-18808-Ljbffr...Remote workSeniorClaims
- ...individual to manage strategic fraud, waste, and abuse activities. This position requires knowledge in healthcare and compliance, with strong experience in medical claims and investigations. Candidates should have a Bachelor's degree and at least 4 years in relevant...Remote workSeniorClaimsFlexible hours
- ...A reputable consulting firm is seeking a Project Manager with expertise in HealthRules Payer claims system to lead complex healthcare projects. The role involves stakeholder engagement, ensuring deliverables are met, and managing project teams effectively. Ideal candidates...Remote workSeniorClaimsFlexible hours
- ...A healthcare intelligence company is seeking a Senior Analyst to lead the development of reimbursement and payment integrity... .... In this role, you will analyze claims data, collaborate with technical... ...skills. The position offers remote work options and a competitive salary...Remote workSeniorClaims
- ...and optimization of business requirements and workflows for the Claims workstream under the QNXT implementation project. This role... ...candidate will have at least 6 years in a similar capacity within the healthcare sector and an ability to design efficient operational processes...Remote workSeniorClaims
- ...depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law... ...leads from various sources to review for suspect activity. Review claim files and develop action plans for the investigation. Conduct highly...Remote workSeniorClaimsWork experience placement
- ...A leading healthcare provider in the United States is seeking a Senior Patient Account Rep - PB EDI Specialist. This role involves managing patient accounts... ...billing and proficiency with electronic claims. Full-time remote work is available for candidates in AR, KS, MO...Remote workSeniorClaimsFull time
- ...A leading healthcare technology firm is seeking a Senior Software Engineer to modernize clinical and claims data exchange systems. The ideal candidate has over 10 years of engineering experience, specializes in high-volume distributed systems, and is proficient in .NET...Remote workSeniorClaimsFlexible hours
$25.38 - $36.76 per hour
...Founded in 1977 as the Senior Care Action Network,... ...we serve. The Job The Quality Auditor will perform routine and... ...but not limited to Claims, Grievances and Appeals... ...experience in the health plan, healthcare, or managed care... ...per hour. Work Mode: Remote. Annual bonus program....Remote workClaimsHourly payWork at office- Norton Healthcare, Inc. is seeking a Sr. Revenue Integrity Pharmacy Analyst responsible for pharmacy charge audits, claims analysis, and collaboration with various teams to ensure compliance. This role offers a fully remote work opportunity for residents of select states...Remote jobSeniorClaims
- Cognizant is seeking a Senior Facets Integration Analyst to support the configuration and validation of the Facets core claims platform for a healthcare Proof of Concept. This remote role entails collaborating with various stakeholders and ensuring accurate claims processing...Remote jobSeniorClaims
$113k - $132k
Cognizant is seeking a Senior Facets Integration Analyst with hands-on expertise in Facets configuration for healthcare claims. This remote role involves supporting the configuration and validation of the Facets claims platform, collaborating with various teams to ensure...Remote jobSeniorClaims
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