Remote Payment Integrity & Claims Recovery Analyst
CareOregon
- Remote job
CareOregon is seeking a Payment Integrity Analyst to execute claims investigation and recovery strategies. This role analyzes claims data to identify cost containment opportunities and conducts audits, coordinating with Clinical, Contracting, Finance, and Claims teams to ensure alignment. The position emphasizes timely, accurate analyses and strong collaboration across departments. Ideal candidates leverage Medicare/Medicaid experience, advanced analytics, and proficient use of claims systems. #J-18808-Ljbffr CareOregon
$50k - $60k
...Our partner is looking for a Claims Recovery Analyst I - Payer based in the... ...This role supports healthcare payment accuracy by identifying and... ...relationships, and payment integrity. The position involves validating... ...–$60,000 USD per year. ~ Remote work environment. ~...Remote workFull timeWork experience placement$65k - $92k
# Payment Integrity AnalystClinical Audit & Revenue IntegrityRemoteJune... ...Job Description**Location:** Remote (US-based)We are seeking a **Payment Integrity Analyst** to identify and document overpayment recovery opportunities across payer claims for a health plan. This...Remote workHourly payFull timeWork at officeLocal areaWork from homeMonday to Friday- ...consistently vote us one of the Best Places to Work in PA. The Payment Integrity Claims Editing Analysis functions to provide analytical, technical... ...problems and requirements in the supported systems. The analyst is responsible for obtaining necessary approvals on systems...SuggestedDaily paidFull timeContract workWork experience placementWork at officeFlexible hours
- ...Care Center is a leading behavioral health provider offering remote Payment Recovery Specialist opportunities. You will support denials... ...causes, and collaborate with billing teams to improve revenue integrity while maintaining patient-focused service. The role emphasizes...Remote jobContract work
- Centene Corporation in the United States seeks a Senior Cost Recovery and Cost Containment specialist to oversee and monitor performance of internal and external cost recovery initiatives for health plans. You will develop annual budgets with national vendors and drive...Remote job
- ...Seeks a Construction Claims Analyst | Construction Engineering... ...No Overtime Pay Basis Remote (within USA - W/ On-... ...holidays.Pre-Tax Payment Programs: Pre-Tax Payment... ...protection during your recovery from a disability.----... ...Above All," emphasizes integrity, overcoming challenges...Remote workFull timeContract workTemporary workFor contractorsWork at officeFlexible hours
- ...Senior Fraud, Waste and Abuse (FWA) Specialist to lead the Payment Integrity and FWA programs, ensuring compliance and effective fraud prevention... ...investigations, reporting, audits, and training, and drive enhancements to recoveries and program #J-18808-Ljbffr PacificSourceRemote job
$98.2k - $163.6k
## Business Analytics Advisor, Payment Integrity - Cigna Healthcare - RemoteApplyremote type: Remotelocations... ...modernization efforts to improve claim accuracy, scalability, and operational... ...fraud, waste and abuse prevention, and recovery optimization—all supported by a rapidly...Remote jobWork from home- ...requirements across diverse contracts. The role emphasizes data-driven investigations, policy development, and collaboration with operating teams to optimize recovery, reporting, and readiness reviews, with flexible remote/hybrid work #J-18808-Ljbffr Centene CorporationRemote workFlexible hours
- ...Corporation in Missouri seeks a seasoned cost containment and cost recovery specialist to oversee performance of initiatives across health... ...process improvements while complying with policies. Flexible remote/hybrid/office options are available. #J-18808-Ljbffr Centene...Remote workWork at officeFlexible hours
- ...6-00877Title: Senior Quality Analyst (Kafka Pipeline, AWS setup, Data Pipelines, Python, Payment integrity)Posted Date: 2026-08-28Contact... ...(Brillio)/ Last option is remote Experience- 7+ Years We are seeking... ..., retries, and failure-recovery scenarios. Validate data accuracy...Remote workContract work
$25.87 - $35.84 per hour
...will never ask applicants to provide payment during the hiring process or extend an... ...often (in days) to receive an alert: Integrated Absence Claims Specialist - West Coast Alternate Locations... ...; Work from Home Work Arrangement: Remote : Work at home employee residing...Remote workTemporary workWork experience placementWork at officeWork from homeRelocation package- ...is looking for a dedicated Payment Integrity to join the team. This role... ...located in these states to work remote - VA, MD, DC, DE, FL, GA, NC... ...payment policies. Analyzes claims, remittances, contractual... ...recoupments to identify overpayment recovery opportunities. Determines...Remote workFull timeContract workMonday to Friday
- ...Payment Integrity Drg Coding & Clinical Validation Analyst The Payment Integrity DRG Coding & Clinical... ...audits acute inpatient claims. Integrates medical chart... ...quality assurance, or recovery auditing, of (MS/APR)... ...may be opportunities for remote work on all jobs posted...Remote workWork experience placement
- ...Revenue Integrity Recovery Coordinator Employment Type: Full-time Shift: Day (Remote) Location: St. Mary's Medical Center Position Purpose Responsible for performing... ...simultaneously. Experience with post payment audits and with coding, clinical and...Remote jobFull timeLocal areaFlexible hoursShift work
- ...Rialtic, Inc. Atlanta or Remote About Rialtic Rialtic... ...’s best‑in‑class payment accuracy product brings... ...with Client Experience Analysts to identify actionable... ...from healthcare claims data and results. Review... ...focused. Values High Integrity - Do the right thing,...Remote workWork from homeHome office
- 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...Remote work
$67.9k - $92.84k
Risk and Claims Analyst I or II We’re hiring a Risk and Claims... ...guaranteed. Hybrid/Remote Work: Following successful... .... Assists with the recovery of restitution and... ...division’s purchasing and payment processes; drafts... ...the City’s values with integrity and accountability, acting...Remote workOngoing contractFull timeTemporary workFor contractorsWork experience placementWork at officeDay shift$87.7k - $157.8k
...preventable readmissions, cost recovery, cost avoidance, and payment accuracy. You will lead a... ...achievement of payment integrity objectives. This role... ...Experience working with payer claims systems preferred. Demonstrated... ...approach to work with remote, hybrid, field or office...Remote workFull timePart timeWork at officeFlexible hours- Inova Health System is seeking a dedicated Payment Integrity professional to join the team. This full-time role operates Monday through Friday with a hybrid schedule and is located in or remote to eligible states. The ideal candidate has 6 years of experience in Payment...Remote jobFull timeMonday to Friday
$87.7k - $157.8k
...Liability (TPL), and Subrogation recovery activities, including... ...processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to appropriately investigate... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timeContract workPart timeWork at officeImmediate startFlexible hours- Abacus Insights is seeking a Complex Clinical Audit (CCA) Business Solutions Lead with 5+ years in payment integrity to translate payer needs into scalable product logic. You’ll work with AI Engineering on backend build, demo capabilities to major payers, and shape how...Remote job
- Centene Corporation seeks a senior leader to supervise the Coding & Clinical Review team within Payment Integrity, ensuring accurate DRG assignments and audit outcomes. This remote role drives quality, efficiency, and adherence to AHIMA standards while coordinating cross-...Remote job
- ...Title: Medicare SME- Payment Integrity Analyst Duration : 12 months Location : Remote This resource will implement a process to test end-... ...issues quickly across the inputs that support claims payment (medical policy, authorization, benefits...Remote work
$24 - $31 per hour
...Payment Integrity Project Coordinator Remote eligible within Oregon, Washington, Idaho or Utah, OR option to work onsite or hybrid from one of our offices. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health...Remote workWork at officeImmediate startWork from homeFlexible hours- ...re a fast-growing fintech in the B2B cross-border payments space, and we need a Payment Operations and Integrations Engineer to ensure our customers have a seamless... ...at a well-funded early-stage startup Fully remote first, with in-person international team offsites...Remote workFull timeWork from homeFlexible hours
- CorVel Corporation is seeking a Payment Integrity Analyst to review pre and post pay claim audits, applying CMS guidelines and client policies. This is a remote position with responsibilities spanning audits, documentation review, and coordination with clinical teams....Remote job
- ...management, and leading Prepay Compliance Managers to reduce waste, abuse, and fraud. Responsibilities also include designing and implementing payment integrity edits, monitoring regulatory changes, and delivering training #J-18808-Ljbffr Centene Management Company LLCRemote job
- A leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role. Candidates must be based in EST or CST and comfortable with EST... ...include analyzing medical records, handling claims, and utilizing systems like Facets and NASCO. Ideal applicants...Remote jobContract work
- ...company, seeks a Senior Product Manager for Professional Claims Review - Payment Integrity. You will define strategy, own roadmaps, and guide cross-... ...GTM to deliver measurable client value. This role offers remote work anywhere in the U.S. with in-office requirements in...Remote jobWork at office
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