Remote Senior Quality Auditor - Healthcare Claims
Centene Corp.
- Remote job
Centene Corporation seeks a Data Analyst to audit and analyze provider data against claims processing systems, supporting cost-saving initiatives and regulatory compliance. You will document audit results, investigate discrepancies, and communicate findings to management while contributing data for training and policy updates. The role emphasizes data accuracy, process improvement, and staying current with health insurance industry standards as Centene supports diverse populations nationwide. #J-18808-Ljbffr Centene Corp.
$100k - $140k
...Job Title: Senior Coding Quality Auditor Department: Compliance Department... ...Time, Exempt Location: Remote with approximately 25% travel... ...compliance and the accuracy of claim submissions. The Auditor... ...state expansions, and tribal healthcare operations, as well as any...Remote workSeniorClaimsFull time$90k - $115k
...principles that guide every decision we make. The Senior Claims Quality Assurance Auditor will conduct regular audits and assessments of Pie's claims... ...Unless otherwise specified, this role is remote. Remote team members must live and work in the United States...Remote workSeniorClaimsFull timeWork experience placement- ...Firstsource Healthcare is seeking a Sr. Revenue Cycle Billing Specialist to successfully collect on aging medical insurance claims, in a remote US setting. The role includes researching denials, attaching necessary documentation, and maintaining claim integrity. The ideal...Remote workSeniorClaims
- ...DVA VHA in establishing a Fraud Rapid Response Center, the remote Senior Healthcare Fraud Investigator will lead case development by reviewing... ...Working knowledge of healthcare fraud laws, including the False Claims Act and Anti-Kickback Statute Experience in developing...Remote workSeniorClaims
- ...Medical Coding Quality Assurance Specialist Turn coding accuracy into stronger compliance, cleaner claims, and better healthcare outcomes. Work Style: Remote Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX) FTE: Full-Time (1...Remote workClaimsFull time
- ...Job Description: Our Senior Quality Associates get to: Define Sutherlands reputation... ...observations. Experience in US Healthcare Knowledge in handling claims process. (Commercial and/or Medicaid... ...ANY EMPLOYMENT DECISION. Remote Work : Yes Employment Type...Remote workSeniorClaimsFull time
- ...SCAN Health Insurance is seeking a Healthcare Analyst II to develop, document, and program for 5-Star... ..., and related tasks to support high-quality care. Your work spans Medicare Advantage data across membership, claims, authorizations, pharmacy, and financial information...Remote workSeniorClaims
$23.23 - $39.61 per hour
...routine pre and post payment claims to determine correct adjudication... ...have the flexibility to work remotely within the continental United... ..., as necessary, for quality improvement indicators, regulatory... ...building your skills while making healthcare more accessible and effective...Remote workSeniorClaimsHourly payFull timeContract workPart timeH1bWork at officeFlexible hours- A health care auditing firm based in Maryland is seeking a Claims Auditor to conduct audits of medical and dental claims. The role requires... ...reviewing claims for compliance and validating eligibility and network participation. #J-18808-Ljbffr HealthCare Resolution ServicesRemote jobClaims
- ...To support complex healthcare clients, the full-time Senior Healthcare Revenue Cycle Specialist will manage billing, collections... ...activities while ensuring timely claim submission and payment resolution, and will work remotely. Key responsibilities Manage billing, collections...Remote workSeniorClaimsFull time
- Premera Blue Cross is seeking a Quality Specialist II to join the Provider Contact Center Quality Program. You will oversee audits of claims processing, enrollments, inquiries and electronic data exchanges, ensuring compliance with BCBS, FEP and corporate policies. This...Remote jobClaims
- ...support practice, the full-time Senior Case Manager will manage a... ...resource for patients and healthcare providers in a remote environment. Key... ...access services and performing quality checks on cases Required... ...and knowledge of medical and claims processing terminology...Remote workSeniorClaimsFull timeWork experience placementWork at office
- Premera Blue Cross is seeking a Quality Specialist II to oversee audits across our provider contact center offshore operations. You will... .... The role requires a high school diploma, 3 years in claims or enrollment with a year in quality auditing, and preferred bilingual...Remote jobClaims
- ...The Senior Claims Analyst will serve as the initial triage and research point for complex healthcare claims and provider-related escalations within a managed care environment. This individual will review incoming operational issues, assess urgency and business impact...Remote workSeniorClaims
- 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 jobSeniorClaimsFlexible hours
- ...professional liability insurance carrier is seeking a Senior Claims Examiner for a remote role. The ideal candidate will have over 7 years of casualty... ...work in a collaborative environment focused on healthcare stability and growth. #J-18808-Ljbffr Polikov Recruitment...Remote jobSeniorClaims
- A healthcare analytics firm is seeking a Data Analyst II who will develop analytical insights... ...payment anomalies in healthcare claims data. The role requires strong proficiency... ...experience in healthcare claims data. This remote position collaborates with teams to translate...Remote jobSeniorClaims
- HonorHealth is seeking a Senior Biller for a hybrid/remote role in the Phoenix area. The role requires strong hospital billing experience, with a preference... ...when required. Responsibilities include submitting claims, reconciling data, and maintaining billing controls. The...Remote jobSeniorClaimsWork at office
- UnitedHealth Group is seeking a Senior Biller for a national remote role overseeing physician billing and AR... ...and coordinate resolution of complex claims while supporting team members with... ...position requires extensive experience in healthcare billing, payer websites, EOBs, and...Remote jobSeniorClaims
- ...hospital, and ancillary providers for network participation. This remote role requires quarterly travel to Woodland Hills, CA and up to 2... ...provider setup and contract configuration to ensure accurate claims adjudication.J-18808-Ljbffr Centene Management Company LLCRemote jobSeniorClaimsContract work
$75k - $165k
...doing it well. Whether you're managing claims, supporting clients, or improving... ...Location: This role is eligible for fully remote work The Senior Claims Specialist within GB Specialty... ...for managing moderately complex Healthcare Professional Liability - Long Term Care...Remote workSeniorClaimsFull timeLocal area- ...Summary: The Litigation Paralegal Senior supports the CHRISTUS Health... ...with legal assertions, claims, and litigation. This position... ...responses to discovery requests for healthcare liability and general... ...clinics regarding in person and remote support for subpoena, pre-...Remote workSeniorClaimsFlexible hours
$76.5k - $149k
...doing it well. Whether you're managing claims, supporting clients, or improving processes... ...: This role is eligible for fully remote work The Claims Specialist within GB... ...responsible for managing moderately complex Healthcare Professional Liability claims, with a primary...Remote workSeniorClaimsFull timeLocal area- ...Engineer opportunity with a healthcare organization seeking a hands-... ...preferred. The role can be worked remotely or in a hybrid capacity in... ...feeds involving healthcare, claims, financial, and operational dataTroubleshoot... ...pipeline failures, and data quality issuesDevelop and maintain...Remote workSeniorClaims
- Gainwell Technologies Company is seeking a Senior Business Analyst to drive healthcare claims processing improvements from a remote setting. You will work with client teams to document requirements, analyze data, and translate business needs into technical solutions. The...Remote jobSeniorClaims
- Revance Therapeutics, Inc. is seeking a Senior Copywriter to craft content for... ...and skincare brands. The role is remote and hands-on, taking briefs to on‑strategy... ...while maintaining brand core claims and staying current on healthcare trends. #J-18808-Ljbffr Revance Therapeutics...Remote jobSeniorClaims
- ...solutions, the full-time Senior BI Analyst will manage... ..., and transform healthcare data into actionable insights while working remotely. Key responsibilities... ...dashboards while ensuring data quality and governance Develop... ...including knowledge of claims, provider, member, and...Remote workSeniorClaimsFull time
$120k - $150k
...TransEleven Claims Managers is looking for a qualified attorney... ...join our team in the role of Senior Claims Counsel , handling a... ...however this position is 100% remote after initial training at our... ...as architects and engineers, healthcare liability (PL/GL) such as...Remote workSeniorClaimsFull timeLive inWork at officeFlexible hours$180k - $220k
...Description Our client is an early-stage healthcare AI company building personalized care... ...eligibility services, clinical partners, and claims infrastructure so delivered care turns... ...competitive early-stage equity. • Remote to start, with relocation to San Francisco...Remote workSeniorClaimsH1bWork from homeRelocationRelocation package- ...Job Description for: Senior Account Executive Location: Remote or Corporate HQ – Gilbert, Arizona About PayGround... ...patient payment technology for healthcare providers, helping organizations... ...about mistakes, and never over-claims a win. Patient financial trust depends...Remote workSeniorClaimsBase plus commissionContract work
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