Medicare/Medicaid Claims Auditor (Hybrid)
American Health Communities
American Health Communities is seeking a Claims Auditor in Oklahoma City, OK. This role involves ensuring accurate claims payment, regulatory compliance, and providing exceptional customer service. Ideal candidates will have at least two years of experience in health insurance claims processing or auditing, along with knowledge of CMS regulations. A coding certification is preferred. The position may require onsite work 2-3 days per week at the Franklin, TN office. Benefits include comprehensive health insurance and a generous paid time-off program. #J-18808-Ljbffr American Health Communities
- ...The role focuses on reviewing and correcting billable claims, managing workflow independently, and complying with insurance... ...a High School Diploma and preferred experience with Medicare and Medicaid billing. This hybrid position requires attendance in-office 3-4 days a week,...ClaimsWork at officeRemote work3 days per week
- ...industry player is seeking a Medicare Billing Associate to join their... ...and managing ambulance claims, ensuring accuracy and compliance... ...Your expertise in Medicare, Medicaid, and private insurance billing... ...offers a blend of in-person and hybrid work options, providing...Claims
$87.5k
...sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All‑Inclusive... ...Brief summary of purpose: The SIU Code Auditor will conduct coding audits of medical... ..., and regulatory support: Assist with claim denial reporting, respond to regulatory...ClaimsLocal area- ...nursing home operators, these Medicare Advantage plans manage... ...pay audits to ensure accurate claims payments and denials Ensure... ...auditing claims for Medicare and Medicaid plans Strong knowledge of CMS... ...automated claims processing systems Hybrid role that may require 2‑3...ClaimsRemote jobFull timeTemporary workWork at officeLocal area2 days per week3 days per week
$59.5k - $63.5k
Progressive Insurance is seeking a claims adjuster trainee who will learn to help customers recover after an accident. The role is not... ...with coaching and training on property damage and contracts. This hybrid position requires residing within 30 miles of Canton, MA,...ClaimsTraineeship- CVS Health is seeking a Program Integrity Auditor to review medical, behavioral,... ...documentation. The role supports audits for Medicaid lines of business, identifies aberrant billing... ...qualify. Qualifications include 3-5 years in claims review and coding (CPT/HCPCS/ICD-10),...Claims
$46.99k - $122.4k
.... Position Summary The Program Integrity Auditor is responsible for the review of records... ...education, recoupment of funds or rebilling of claims, and referral to state regulators for any... ...which currently administers benefits to Medicaid members across multiple lines of business...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...services is seeking a detail-oriented billing specialist. This hybrid position allows for a blend of in-office and remote work,... ...experience with various insurance billing processes, including Medicare and Medicaid, and possess strong problem-solving skills. Join a team...ClaimsWork at officeRemote work
- ...Responsibilities: Review and correct all billable claims Follow-up claim status check/rejection... ...Qualifications: Experience with Medicare, Medicaid and/or MVA, VA and Commercial Insurance... ...have access to high-speed internet Hybrid position in the Oklahoma City Area. In...ClaimsWork at officeLocal areaRemote work2 days per week3 days per week1 day per week
- A growing claims management firm in Oklahoma City is seeking a Senior Subrogation Claims Specialist to manage high-value claims and total... ...and efficiency in claims management tools. This position offers hybrid work flexibility with competitive benefits including medical,...Claims
- Job Summary Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims... ...providing updates. Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of...ClaimsWork experience placement
- Qlarant is looking for a skilled auditor in the United States, Massachusetts to ensure the integrity and accuracy of claims processes. This role involves conducting routine audits, providing detailed reports, and implementing strategies to prevent fraud. Applicants should...Claims
- Express Employment International is seeking a Work Authorization Auditor to join their Corporate Headquarters in Oklahoma City, OK. In this pivotal role, you will conduct thorough audits of Form I-9 documents and E-Verify cases, ensuring compliance with federal regulations...Work at officeRemote work
- ...accepting applications for a Medicare Billing Associate in Oklahoma... ...analyzing, and managing ambulance claims for assigned payor types.... ...insurance, Medicare, Medicaid, HMO's and clients to collect... ...must be hardwired In person and hybrid in the Oklahoma City area Physical...ClaimsFull timeLocal area
- ...Bristol West Claims Liability Claims Representative-Hybrid 34763 We are Farmers – where ambition meets opportunity. At Farmers, we're a team with a passion for purpose and making a real difference in people's lives. We deliver peace of mind when it matters most. Our...ClaimsFor contractorsTraineeshipWork at officeFlexible hoursShift work
$106.9k - $147k
...Associate Actuary will support Medicare Market & Provider Finance... ...insights using actuarial methods, claims data, reimbursement... ...Requirements To ensure Home or Hybrid Home/Office employees' ability... ...for people with Medicare and Medicaid, families, individuals, military...ClaimsFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome office- ...billing standards while managing a team of medical billers. The ideal candidate has significant experience in medical billing and claims processing, with strong technical and leadership skills. We offer a competitive benefits package that includes insurance and paid time...Claims
$223.8k - $313.1k
...medical background and reviews health claims. The Medical Director work... ...utilization management or inpatient review (Medicare Advantage, Managed Medicaid, or Commercial lines of business).... ...Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to...ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work- A healthcare service provider in Oklahoma City is seeking a Medicare Billing Associate responsible for processing and managing ambulance claims. The ideal candidate will have knowledge of Medicare, Medicaid, and private billing. Key responsibilities include timely claims...Claims
- ...Emergency Medical Services is seeking a Medicare Billing Associate in Oklahoma City. The role... ...processing and managing ambulance claims, ensuring compliance and accuracy with regulations... ...-time position allows for in-person and hybrid work in the Oklahoma City area....ClaimsFull time
$86.3k - $118.7k
...position is compliance related to Medicare Pharmacy and Part D programs.... ...the Centers for Medicare & Medicaid Services ?(CMS) Program Audit... ...pharmacy operations and/or claims processing within a pharmacy... ...Statement To ensure Home or Hybrid Home/Office employees'...ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...under the benefit design (Commercial, Medicare, Medicaid) Serve as a payer expert for defined geography... ..., prior authorization, appeal, and/or claims resolution Educate offices using... ...Flexible work models, including remote and hybrid work arrangements, where possible...ClaimsFull timeWork at officeRemote workWork from homeHome officeFlexible hours2 days per week3 days per week
$65k - $85k
Join Sedgwick as a Claim Examiner in Oklahoma City, where you will manage complex general liability claims from investigation through resolution. Collaboration with clients and maintaining regulatory compliance are essential parts of this role. Candidates should have a...ClaimsFlexible hours- ...process for home healthcare services. Process and submit medical claims accurately and efficiently. Verify patient insurance... ...Payment postingDenial management and appeals Knowledge of Medicare, Medicaid, and commercial insurance plans . Prior experience in a remote...ClaimsFull timePart timeRemote workFlexible hours
- ...patients with payment arrangements, charity applications, and Medicaid/state aid applications. Monitor and maintain patient financial... ...carriers or financial institutions. Review outstanding insurance claims and coordinate follow-up with billing staff. Prepare medical...
- ...timely to support maximum reimbursement. Researches insurance claim denials, determines claim validity, and adjusts and... ...year of responsible administrative experience and knowledge Medicare and Medicaid billing required. Ability to organize and manage large volumes...ClaimsWork at office
- ...Senior Auditor LHH is seeking a Senior Audit Associate to join a growing firm in Oklahoma City, OK. The ideal fit will maintains a... ..., and responds in ways that benefit both clients and the firm. Hybrid remote flex is offered. This position offers a great work life...Local areaRemote workFlexible hours
$110k - $150k
...staffing agency is seeking a Mid-Senior level Audit Manager to join a Top25 National CPA Firm in Oklahoma City. This role offers a hybrid schedule and significant career growth opportunities. The candidate will be involved in various industries and is expected to enhance...- ...protected status. Job Summary: Reviews billing data of unpaid claims. Responsible for calling insurance companies and or checking... ...payer operating procedures and practices. Knowledge of Medicare requirements. Skills: Proficient skills in computer...ClaimsWork at officeMonday to ThursdayShift work
$20 - $28 per hour
...You’ll be instrumental in managing and resolving insurance claims, contributing to the financial health of the organization. Key... ...cycle Knowledge of third‑party reimbursement, including Medicare and Medicaid Experience with Medicare online system Good investigative skills...ClaimsWeekly pay
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