Hybrid Medicare Claims Auditor - Network Management
$43.89k - $85.07kCVS Health Corporation
CVS Health Corporation is seeking an Analyst, Network Management to join their specialized Pharmacy Audit division. This role entails conducting compliance audits and verifying pharmacy-submitted claims related to Medicare, ensuring adherence to CMS standards. The ideal candidate will possess strong communication skills and familiarity with pharmacy claims processing. This full-time position offers a competitive salary range of $43,888 - $85,068 and benefits including medical, dental, and vision coverage. #J-18808-Ljbffr CVS Health Corporation
- ...At AZ Blue, we have a hybrid workforce strategy, called... ...to: Customer Service, Claims Processors, and... ...more experience in the managed care pharmacy field Required... ...years of experience with Medicare Part D formulary and utilization... ...to FEP members and/or network providers on medication...NetworkClaimsFull timeWork experience placementWork at officeRemote workFlexible hoursShift work1 day per week
- ...minimum of 5 years of experience in healthcare, with specific qualifications as an RN analyst in Utilization Review or Care Management. This position promotes a hybrid work environment, emphasizing flexibility and teamwork. #J-18808-Ljbffr Blue Cross Blue Shield of ArizonaClaims
- Forest Recruiting Group aka Affiliated Recruiters Network is seeking an Audit Manager for its new office in Scottsdale, Arizona. This role provides... ...license. The firm values work/life balance, offers a flexible hybrid schedule, and presents fast track promotion...NetworkWork at officeWork from homeFlexible hours
- Director of Complex Claims & Counsel page is loaded##... ...opportunity for you.A network with resources for leaders... ...Health.This role is hybrid for Arizona residents with... ...In this role you will manage claims and litigation... ...deadlines for meeting Medicare, Medicaid, Ship Extension...NetworkClaimsShift work
- ...Matrix Absence Management, Inc. is offering a Summer Intern Program in Phoenix, AZ, designed... ...students hands-on experience in the claims lifecycle including intake, documentation... ...performers. Interns will also benefit from a hybrid office setup and a paid opportunity,...ClaimsFull timeInternshipSummer internshipWork at office
$63.59k - $114.45k
.... This role offers stability and strong support as you manage complex property insurance claims primarily via telephone. Candidates should have 2 years... ...The compensation ranges from $63,590 to $114,450, with a hybrid work schedule and comprehensive benefits including...Claims- AmTrust Financial Services is seeking a Transportation Liability Claim Specialist to manage insurance claims with efficiency and effective research in a hybrid work environment. The role requires investigating claims, establishing reserves, and negotiating outcomes to...Claims
- ...Manager - Buyer and Procurement Operations Job Category : Finance... ...Posted : April 24, 2026 Full-Time Hybrid Locations Showing 1 location... ..., strengthening supplier networks, and contributing to the successful... ...workflows Support freight claims and damage resolution with...NetworkClaimsFull timeWork at officeRemote workFlexible hours
- ...firm in Scottsdale is seeking a Transportation Liability Claim Specialist to efficiently manage insurance claims with strong negotiation and... ...with a Bachelor's degree. This position operates under a hybrid schedule, allowing flexibility in the work environment....Claims
- A prominent healthcare organization is seeking a Director of Complex Claims & Counsel in Phoenix, Arizona. This hybrid role involves managing complex claims, providing legal counsel on risk management, and developing litigation strategies. Ideal candidates will have notable...Claims
- ...defense litigation law firm, is seeking a National Litigation & Claims Management Attorney in Phoenix, Arizona. The ideal candidate will... ...This position provides flexibility with in-person, remote, or hybrid arrangements, and offers excellent benefits, career growth opportunities...ClaimsRemote job
- AI Program Manager - Power Delivery & Grid The AI Program Manager -... ...Distribution, Battery Energy Storage, Network & Communications). They will... .... The Opportunity This is a hybrid leadership position, balancing... ..., and compliance. Lead claims and commercial recovery as needed...NetworkClaimsFlexible hours
$86.4k - $129.6k
The Hartford is seeking a Team Leader Claims in Scottsdale, AZ. This role involves leading a team of claim handlers, managing investigations, and training staff to achieve their... ...skills. The position offers a hybrid or remote work arrangement depending on your...ClaimsRemote job- ...of property, casualty, risk management, life and health, employee benefits... ...Choose HUB? Throughout our network we offer a competitive,... ...and carriers. Troubleshoots claims and billing issues. Responsible... ...ability to work independently. Hybrid work schedule; must be onsite...NetworkClaimsWork at officeLocal areaFlexible hours3 days per week
$50k - $65k
Cannon Cochran Management Services, Inc. is seeking a Claim Representative, Medical Only Senior in Phoenix, AZ. This role involves managing medical-only... ...and strong communication skills. The position offers a hybrid work model with a competitive salary range of $50,000...Claims$71.1k - $97.8k
...Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate... ...matching program ~ Network Resource Groups (NRGs)... ...Requirements To ensure Home or Hybrid Home/Office associates'... ...life for people with Medicare and Medicaid, families,...NetworkBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayFlexible hours$60.6k - $95.7k
IAT Insurance Group is seeking a Management Liability Claims Specialist to manage various claims in a hybrid setting. This position may be performed remotely part-time but prefers candidates to work from IAT office locations. Qualified applicants should have a Bachelor'...ClaimsPart timeWork at officeRemote work$105k - $160k
...services through a nationwide network of independent agents and... ...collaborative and inclusive management team, our company’s success is... ...of parental and bonding leave Hybrid work schedule (3 days in the... ...Companies is seeking a Trucking Claims Specialist to join our P&C Claims...NetworkClaimsWork at office- ...an Employee Benefits Account Manager at Amwins Self‑Funded! Are you... ...Amwins? Flexibility: Enjoy a hybrid work environment with... ...pricing, account management, claims administration, and premium services... ...relationships via email, telephone, and networking opportunities to strengthen...NetworkClaimsContract workWork experience placementWork at officeLocal areaWork from homeFlexible hours2 days per week
$82.2k - $157.6k
Snc-Lavalin is seeking a Contract/Claims Manager for Energy and Infrastructure Projects based in Phoenix, AZ. This hybrid role consists of serving as a commercial advisor, leveraging 5-8 years of construction experience to shape contract strategy and minimize risks throughout...ClaimsContract work$27.14 per hour
Avenica is seeking a detail-oriented Claims Associate in Phoenix, AZ, focusing on Auto and General Liability claims. This position... ...involves structured training to build expertise in claims management, with a hybrid work model after training. Successful candidates will hold...ClaimsHourly pay$105.1k - $192.6k
...Sales & Use Lookback Review COE - Manager Will you shape the future or... ...sales and use tax refund claims Participate on a motivated team... ...with impact. Emotional agility. Hybrid collaboration. Complex problem... ...connected, multi-disciplinary network and diverse ecosystem partners...NetworkClaimsSummer holidayFlexible hours$66.9k - $91k
...for a Telephonic Medical Case Manager, RN. Primary Purpose To provide... ...holistic approach for each claim. These responsibilities may include... ...care coordination. Location: Hybrid, out of Irvine, CA; Scottsdale... ...of care to preferred provider networks where applicable. Addresses...NetworkClaimsWork experience placementWork at officeFlexible hours- ...talented and experienced Project Manager to lead and deliver complex... ...managing risk, and resolving project claims and disputes. Proficient in... ...and innovation. Flexible hybrid work options to support work-... ...balance. Access to AECOM's global network, technical resources, training...NetworkClaimsContract workLocal areaRemote workFlexible hours
- ...decisions. At AZ Blue, we have a hybrid workforce strategy, called... ...to: Customer Service, Claims Processors, and Correspondence... ...description is primary for case management functions but can assist with... ..., BCBSAZ programs, provider networks, etc. Analyze medical records...NetworkClaimsFull timeContract workWork experience placementWork at officeRemote work1 day per week
- ...Phoenix, AZ is seeking a Senior Internal Auditor to support SOX compliance and audit projects... .... You will work closely with the Senior Manager, Internal Audit to ensure timely... ...ability to communicate effectively. This hybrid role offers a dynamic work environment, combined...
$91.1k - $143.6k
...Communicate regularly with Engagement Managers (Directors), project team... ...teams, infrastructure/network/security, and vendors to deliver... ..., data, AI, network, and hybrid cloud infrastructure. These solutions... ...features). Knowledge of X12 (claims/EDI) for revenue cycle...NetworkClaimsVisa sponsorship- ...make better health decisions. Hybrid Workforce Strategy Hybrid... ...limited to: Customer Service, Claims Processors, and Correspondence... ...oversight for medical management activities related to utilization... ...Marketing, Sales, Legal, Actuarial, Network Management, Internal Audit,...NetworkClaimsWork at officeRemote work1 day per week
- This position is hybrid within the state of Arizona only... .... Purpose of the job Network Adequacy and... ...experience in Medicaid or Medicare such as practice administration... ..., or members services, claims and encounters... ...Ability to prioritize and manage work assignments and work...NetworkClaimsFull timeContract workWork experience placementWork at office
$138.1k - $315.6k
...commercial strategy Effectively manage and motivate client engagement... ...term client relationships and networks Developing relationships with... ...databases, prescription and claims databases) Experience with... ...time off options. We work in a hybrid model, with most external client...NetworkClaimsFlexible hours
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