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
$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... ...) that currently administers benefits to Medicaid members across multiple lines of business...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$53.1k - $72.5k
...initiative and judgment. The Medical Coding Auditor confirms correct CPT coding... ...expense. • Humana will provide Home or Hybrid Home/Office associates with telephone... ...better quality of life for people with Medicare and Medicaid, families, individuals, military...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$146.24k - $152.24k
...Psychologist (Hybrid)The psychologist performs Medical Disability Examinations (MDE)... ...for veterans when they file disability claims mental health conditions (e.g. PTSD, Depression... ...ReviewsExperience with Commercial, Medicaid and Medicare lines of businessExperience with CPT...ClaimsFor contractorsFor subcontractorWorldwide- ...cloud hosting, integration and interoperability, clinical and claims application implementation, revenue cycle management and policy... ...experience as a business analyst, systems analyst, or developer in a Medicaid environment5 years of experience working on large, complex DDI...ClaimsFor contractorsFlexible hours
- 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
$80k - $150k
...AuditorEmployment Type: Full Time, Mid-levelDepartment: Financial Services CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-...ClaimsFull timeFlexible hours- Job Posting Title: Claims Auditor I Agency 740 STATE TREASURER Supervisory Organization Office of the State Treasurer Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Estimated Appointment End Date (Continuous...ClaimsFull timePart timeWork at office
- 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
- ...scale product efforts focused on improving claims processing and related systems,... ...balancing competing priorities across Medicare, Medicaid lines of business. Serve as a key decision... ...internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone...ClaimsBi-weekly payApprenticeshipWork from homeHome office
$106.9k - $147k
...assumptions as part of a granular Medicare Advantage underwriting margin... ...to the methodology of claims/premium forecasting and eventually... ...: To ensure Home or Hybrid Home/Office employees' ability... ...for people with Medicare and Medicaid, families, individuals, military...ClaimsFull timeTemporary workApprenticeshipRemote workWork from homeHome office$48.3k - $65.9k
...when there is a dispute on adjudicated claims that contain a code editing related denial... ...coding issues Experience with Medicare and Medicaid coding guidelines Strong data entry... ...expense. • Humana will provide Home or Hybrid Home/Office associates with telephone equipment...ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$65k - $88.6k
...Business areas for all product lines (Medicare, Medicaid, Commercial) o Industry Trend areas... ...Knowledge of healthcare payment methodologies, claims, submissions, and payments • Strong... ...Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work...ClaimsFull timeTemporary workFor contractorsApprenticeshipWork experience placementWork at officeLocal areaRemote workWork from homeHome officeMonday to Friday$43.89k - $69k
...ScheduleThis role may involve work from home, full-time in-office, or a hybrid arrangement. The specific work arrangement will be determined by... ...of an increase in recruitment scams where individuals falsely claim to represent AML RightSource. These scammers may ask for money...ClaimsOngoing contractFull timeH1bWork at officeLocal areaWork from homeVisa sponsorshipMonday to Friday$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$75k - $95k
...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- ...billing, pursuing reimbursement, customer service, and record keeping Key Responsibilities: Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior...ClaimsWork at officeRemote work
$130k - $140k
...Summary We are seeking an experienced IT Audit Manager for a hybrid remote opportunity with a longstanding client in Oklahoma City,... ...Technology experience. Certified Information Systems Auditor ( CISA ) certification. Strong experience leading complex audit...Local areaRemote work- ...Claims Processor GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and... ...contracted claims accurately and timely for Medicare, Medicaid and Commercial Insurance products. The Claims...ClaimsRemote work
- ...Financial Auditor Oklahoma City, OK, United States About the Job Financial Auditor Why You'll Love This Auditor Position... ...opportunities Supportive and collaborative work environment Hybrid work schedule Job Duties and Responsibilities Embody...
$17 per hour
...Manage customer accounts and update information in the database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters to ensure timely policy issuance. Qualifications Strong...ClaimsHourly pay- ...processing customer bills and insurance claims in an accurate and timely manner. This includes... ...or responsible party by running Medicare plan comparisons during open enrollment... ...facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third...ClaimsFull timeTemporary workLive inWork at officeRemote workFlexible hours
- A nationwide claims adjusting firm is seeking Licensed Claims Adjusters to join their team. This role offers comprehensive training programs to equip you with the skills needed to succeed in the insurance claims industry. Ideal candidates will be licensed adjusters with...Claims
- A leading claims adjustment agency in Oklahoma City is seeking Independent Insurance Claims Adjusters to join their team. This role involves assisting clients affected by natural disasters, while offering flexibility and autonomy in work. The company provides comprehensive...ClaimsFlexible hours
- ...Senior Vice President, Head of Claims Intake About the Company Insurance claims operations leader focused on efficient intake, reporting, and client relations. Industry Insurance Type Privately Held About the Role The Company is seeking an SVP,...Claims
- ...admission/discharge/transfer or billing/claims management software Previous... ...scheduling, registration, insurance (including Medicare, Medicaid, and third-party regulations), billing,... ...Oklahoma City, OK, United States (Hybrid) Degree Level High School Graduate...ClaimsFull timeWork at officeImmediate startShift workDay shift
- A dynamic claims adjusting company in the United States is seeking Independent Insurance Claims Adjusters to meet the urgent need for professionals following storm-related events. The role offers flexibility and competitive compensation, along with comprehensive training...ClaimsFlexible hours
- A leading insurance claims organization is seeking Independent Insurance Claims Adjusters in Bethany, Oklahoma. This role offers a path for both experienced and new adjusters, with training programs designed to equip you with essential skills. You'll help clients recover...ClaimsFlexible hours
- ...Manage customer accounts and update information in the database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters to ensure timely policy issuance. Qualifications: Strong...ClaimsFor contractors
$600 per month
...roofing sales consultant, you'll be out in the field connecting with homeowners, performing inspections, and navigating them through the claims process with the support of a powerhouse team behind you.We offer $600 four weeks for training pay and weekly pay-plus uncapped...ClaimsWeekly payLocal area- ...Serco is seeking a board-certified physician to provide medical insight for Medicare claims reviews and national coverage matters. The role reports to the Program Director and interacts with CMS contractors, medical societies, and stakeholders. Responsibilities include...ClaimsFor contractors
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