Healthcare Claims & Contract Auditor
$49.43k - $107.1kMolina Healthcare of Illinois
Molina Healthcare is seeking an experienced professional for a position focused on contract review and target claim audits. The role involves validating claims data and ensuring compliance with business requirements. The ideal candidate should possess comprehensive experience in claims processing and auditing. The position offers a competitive compensation package based on qualifications, with salaries ranging between $49,430.25 and $107,098.87 annually. #J-18808-Ljbffr Molina Healthcare
- RN Inpatient Hospital Auditor - Remote (New Jersey) - 6‑month contract, 3+ years experience - Start date: ASAP - Worker type: W2. Core Requirements Must... ...found during audit and coordinates referral of improper claim payments through the appropriate channels....Contract workClaimsRemote jobWeekly payDaily paidLocal areaImmediate start
- A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...ClaimsRemote work
- Join to apply for the Premium Auditor role at Kismet Recruiting Group Join to apply for the... ...that seamlessly combine innovative claims resolution, risk management, and loss prevention... ...level Employment type Employment type Contract Job function Job function Accounting/Auditing...Contract workClaimsPart timeLive inWork at officeRemote work
- ...Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families,... ...the auditing functions of Centers Plan for Healthy Living (CPHL) claims. Collaborates with other Health plan departments and Management...Claims
$46.99k - $122.4k
Hispanic Alliance for Career Enhancement in Georgia is hiring a Program Integrity Auditor responsible for auditing healthcare records. This role requires 3-5 years of experience in claims data review and medical coding standards (CPT, HCPCS, ICD-10). Candidates should hold...Claims$46.99k - $122.4k
...Alliance for Career Enhancement is seeking a Program Integrity Auditor based in New Jersey. This role involves auditing medical records... .... The ideal candidate will have 3-5 years of experience in claims data interpretation and hold certifications such as CPC or CCS....ClaimsFull time$90k - $115k
A healthcare intelligence company is seeking a DRG Reviewer to conduct payment validation reviews. The ideal candidate will possess a nursing... ...degree or equivalent, with at least two years of inpatient claims auditing experience. Responsibilities include auditing medical...ClaimsRemote jobFlexible hours- A government services firm is seeking a Senior Auditor in the United States to conduct forensic financial investigations and analysis related to healthcare claims. The ideal candidate has 5+ years of experience in forensic accounting and a strong understanding of legal...Claims
$85k - $90k
...to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions... ...leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals...ClaimsRemote work- Overview The Contract Auditor, Technical Specialist I, Product Climate Verification is responsible for supporting the Critical Review and Verification... ...I in the US. Relevant Services / Schemes Environmental Claims Validation ISO 14025 Environmental Labels and Declarations -...Contract workClaimsWork at officeLocal areaRemote workHome office
$29 - $34.25 per hour
Cotiviti is seeking a Payment Accuracy Specialist 2 to enhance healthcare payment integrity through audits and claims recovery. This role requires strong healthcare industry experience, proficiency in Microsoft Excel, and excellent communication skills. You will work under...ClaimsHourly pay$100k - $102.5k
...accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment... .... The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate...ClaimsRemote work$85k - $90k
...waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common... ...parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG...ClaimsWork at officeRemote work$70k - $85k
...practices. We are the premier independent healthcare payment integrity company in the US and... ...lives for all. Medical Coding Auditor - Inpatient (Remote) Location: Remote. Full... ...and medical chart review for all provider/claim types. Experience coding for emergency...ClaimsFull timeWork at officeRemote workHome office- Molina Healthcare is seeking a compliance auditor to provide audit support for Social Adult Day Centers, ensuring adherence to state regulations. The role... ...in the healthcare field, a strong understanding of contract management, and familiarity with Medicaid and Medicare...Contract work
- ...provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to diagnostic... ...session. Services rendered under this role will support claims submitted to federal payers. As such, strict adherence to documentation...Contract workClaimsRemote workFlexible hours
$85k - $90k
A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful...Claims$18 - $20.57 per hour
...Hospital Billing (HB) Type: 12-month rolling contract Location: Fully Remote Start Date: ASAP... ...one of the nation’s leading non-profit healthcare systems to expand their Hospital Billing... .... Analyze and resolve denied or unpaid claims. Navigate Medicare/Medicaid and...Contract workClaimsWeekly payLong term contractFull timeWork at officeImmediate startRemote work- ...end-to-end Revenue Cycle support services to healthcare providers. Our highly skilled professionals assist with claims processing and submission, denials management,... ...initiatives. Role Description This is an Interim contract remote role for a Hospital Follow-up/...Contract workClaimsInterim roleRemote work
- ...Healthcare Team Lead at The Judge Group Job Title: Medical Testimony Provider Location: Remote... ...medical evidence in disability claims. This flexible opportunity allows providers... ...level Mid-Senior level Employment type Contract Job function Health Care Provider Industries...Contract workClaimsDaily paidRemote workFlexible hoursShift work
- ...(EST / CST preferred) Employment Type: Contract (Full-Time or Part-Time) About the Role... ...in Latin America to support U.S.-based healthcare providers. This role is ideal for candidates... ...with authorizations Support billing, claims follow-up, and documentation Prepare...Contract workClaimsLong term contractFull timePart timeRemote work
- ...Appeals Nurse examines medical records and claims information for first-level appeal cases... ...regulations. Maintain awareness of healthcare laws, regulations, and policies relevant... ...for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all...Contract workClaimsFor contractorsImmediate startRemote work
- ...twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental... ...(like self promotion and scheduling). We are looking for contract nurse practitioners (NPs) or certified physician assistants...Contract workClaimsFull timeFor contractorsWork at office
$70k - $80k
...units: - Engineering Audit. - Vendor Contract Audit. - Internal Audit. - Non-Public... ...the International Association of Internal Auditors (IIA) and with the Generally Accepted... ...reviews/audits and analyze reimbursement claims, conduct field/site visits to ensure compliance...Contract workClaimsPermanent employmentFull timeLocal area- A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing... ...years of related experience. This contract opportunity offers highly competitive...Contract workClaimsRemote job
- ...Role Organization: Alignerr Type: Hourly Contract Location: Remote Commitment: 10-40... ...You Are Hands‑on experience working with healthcare, public health, or population‑level... ...with surveillance systems, EHR data, or claims‑based datasets. Experience working with...Contract workClaimsHourly payOngoing contractFreelanceRemote workFlexible hours
- ...Resolute PB Analyst for a 6-month fully remote contract opportunity. The analyst will focus on... ...optimizing various processes within the healthcare environment. Key responsibilities... ...configuring charge capture workflows, managing claims, and developing reporting tools. Strong...Contract workClaimsRemote job
- A leading staffing and recruiting firm is looking for a Healthcare Claim Analyst (Provider Side) for a 5-6 month remote contract role. You will be responsible for handling inbound and outbound calls from healthcare providers and members, focusing on claims support, eligibility...Contract workClaimsRemote job
- A leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role... ...include analyzing medical records, handling claims, and utilizing systems like Facets and... ...Excel skills. This mid-senior level contract position is perfect for detail-oriented...Contract workClaimsRemote job
$90 - $110 per hour
...Pennsylvania in navigating this transformation as it relates to healthcare data interoperability. You will help Pennsylvania decide what... ...for each priority rural provider archetype Map how clinical and claims data actually move across Health Information Organizations (HIOs...Contract workClaimsHourly payFor contractorsWork at officeRemote work
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