Remote Health Plan Quality Auditor - Claims & Compliance
$25.38 - $36.76 per hourSHPCA SCAN Health Plan
California, MO
- Remote job
SHPCA SCAN Health Plan is seeking a Quality Auditor to conduct compliance audits across various health plan operations. This role ensures quality standards, compliance with regulatory requirements, and identifies areas for improvement to enhance our member and provider experience. The ideal candidate should possess auditing experience in health plans, strong organizational and analytical skills, and be proficient in Microsoft Office. This position offers a remote work option and a competitive pay range of $25.38 to $36.76 per hour. #J-18808-Ljbffr SHPCA SCAN Health Plan
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Health Plan Quality Auditor - Claims & Compliance in California, MO vacancy
$25.38 - $36.76 per hour
...SCAN is a nonprofit health organization... ...serve. The Job The Quality Auditor will perform routine... ...audits across health plan operations... ...but not limited to Claims, Grievances and Appeals... ...Materials to ensure compliance with regulatory... ...hour. Work Mode: Remote. Annual bonus program...Remote workClaimsHealth InsuranceHourly payWork at office- ...Working remotely in a full-time capacity, the Quality Assurance Auditor will conduct systematic investigations of operations,... ...to enhance service and quality compliance within the organization. Key responsibilities... ...skills, with knowledge of claims, service, and enrollment...Remote workClaimsFull timeWork experience placement
Virtual Vocations Inc
United States10 hours ago $25.38 - $36.76 per hour
Scan-Health-Plan in California is seeking a Quality Auditor to perform operational audits across various... ...operations including Claims and Enrollment.... ...Responsibilities include ensuring compliance with regulatory... ...$36.76 per hour and a remote work option. #J-18808-...Remote jobClaimsHealth InsuranceHourly payWork at office- Claims Quality Analyst | Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor... ...key role in ensuring the accuracy, compliance, and effectiveness of claims processing... ...focus on Medi‑Cal and commercial health plans. This role is responsible for...Remote jobClaimsHealth InsuranceFull time
- ...completeness, and quality of pharmacy-related... ...quality Ensure compliance with applicable state... ...and pet insurance plans. Employees receive... ...are provided for remote workspace. ABOUT... ...200,000 insurance claims annually for leading... ..., Auto, and Group Health Carriers, Third-...Remote jobClaimsHealth InsuranceTemporary workWork at officeWork from home
$129.3k - $177.8k
...decisions. The role includes providing insights into medical claims trends and advising executives on significant issues.... ...$129,300 - $177,800 per year and is eligible for a bonus incentive plan. Benefits include health coverage and retirement plans. #J-18808-Ljbffr...Remote workClaimsHealth InsuranceHumana
Boston, MA2 days ago- ...Warrenville, IL seeks a Senior Coding Quality Auditor to conduct compliance audits, communicate results, and... ...career growth pathways, and various health plans. A hybrid work model allows for flexibility between on-site and remote work. #J-18808-Ljbffr NorthShore University...Remote workHealth InsuranceFull time
- ...MedPOINT Management is seeking a Hospital Claims Auditor responsible for ensuring the quality of claims processes and compliance with health plan and hospital regulations. The role... ...expertise in medical coding and contracting. This is a remote position. #J-18808-Ljbffr...Remote workClaimsHealth Insurance
MedPOINT Management
Los Angeles, CA3 days ago - Optum is seeking a Clinical Claim Review Nurse to perform claim reviews and ensure compliance in a telecommute role. You will verify... ...coding accuracy and support health outcomes by connecting people... ...comprehensive benefits, including health plans, paid time off, and a flexible...Remote jobClaimsHealth InsuranceFlexible hours
- ...seeking a Business Analyst who can work fully remote but must adhere to PST hours. This role... ...validate and document requirements for health plan initiatives. Candidates should have at... ...actionable requirements. Knowledge of claims processing and tools like Facets is advantageous...Remote jobClaimsHealth Insurance
- ...intelligently speak to what a claim is Someone that... ...Philadelphia, PA (70% remote) looking local... ...transformation across our health insurance portfolio. This... ...Business Operations, and Compliance teams to design and... ...prioritization, and roadmap planning. • Ensure alignment...Remote workClaimsHealth InsuranceLocal area
Damco Solutions
Philadelphia, PA4 days ago $96k - $125k
...Litigation Specialist for a remote position. The ideal candidate... ...experience and handle claims in the Mid-Atlantic Region and... ...negotiating settlements, and ensuring compliance with legal requirements. The... ..., along with comprehensive health care plans and other benefits. #J-18808...Remote jobClaimsHealth Insurance- ...This position can be fully remote but must work PST hours Responsibilities... ...functional requirements for health plan initiatives. Analyze and... ...state workflows related to claims processing, enrollment,... ...align with regulatory and compliance requirements (e.g., CMS, HIPAA...Remote workClaimsHealth Insurance
Insight Global
Portland, OR2 days ago $130k - $168k
...two days onsite; three days remote with travel for legal... ...Comprehensive benefits include health coverage, retirement plan with employer match, paid... ...effectively with clients, claims professionals, opposing... ...to internal teams Maintain compliance with professional standards...Remote workClaimsHealth InsuranceWork at officeFrink-Hamlett
Hartford, CT3 days ago$80k - $90k
Clever Care Health Plan seeks a Supervisor for Medicare Claims to manage operations in Huntington Beach, CA. This position ensures compliance and operational excellence in claims processing, fostering staff development and performance. The ideal candidate has a bachelor...Remote jobClaimsHealth Insurance- ...Indemnity Company is seeking a claims professional for... ...party property claims. This remote position requires... ...claims while maintaining compliance with quality standards. Ideal candidates... ...Attractive benefits include health insurance, a pension plan, and a generous PTO...Remote jobClaimsHealth Insurance
- ...Department of Community Health (DCH) is one of... ...Health Benefit Plan (SHBP) and Healthcare... ...to affordable, quality health care to millions... ...the position of Compliance Specialist 3, in... ...3 will analyze claims data to identify aberrant... ...in-office and remote work with the...Remote workClaimsHealth InsuranceWork at office
State of Georgia
Atlanta, GA2 days ago $17.46 per hour
...Location Address: Remote Office Santa Fe, NM 875... ...performs validation of claims payment against payer contract... ...terms to ensure payer compliance. Requires detailed... ...to enhance your health and activate your well-... ...hospitals, a statewide health plan and a growing multi-...Remote workClaimsHealth InsuranceFull timeContract workTemporary workWork at officeLocal areaImmediate startShift workPresbyterian Healthcare Services
Santa Fe, NM10 hours ago- Hiscox Inc. is seeking a Claims Compliance and Quality Assurance Manager who will oversee the maintenance of a 50-state claims database and ensure... ...the office. The offered benefits include comprehensive health plans, 401(k) matching, and 24 paid time off days. #J-18808-...Remote jobClaimsHealth InsuranceWork at office
- Curative Health Plan is seeking a Sr. Director, Claims Operations in Austin, Texas. This role involves overseeing end-to-end claims operations, ensuring accuracy and compliance while driving operational efficiency. The ideal candidate will have 10+ years in claims operations...Remote jobClaimsHealth InsuranceFlexible hours
- ...involves managing and litigating personal injury claims while offering legal advice to ensure regulatory compliance. The ideal candidate will possess a JD, be... ...and offers comprehensive benefits including health, retirement plans, and paid time off. #J-18808-Ljbffr United...Remote jobClaimsHealth InsuranceFlexible hours
$24 - $25 per hour
...Jul 6, 2026 This is a remote role, however, the team may... ...interests and uphold legal compliance. Your expertise will... ...Assess and negotiate warranty claims. * Collect and organize... ...benefits like subsidized health, vision, and dental plans, paid sick leave, and...Remote workClaimsHealth InsuranceHourly payTemporary workSkill Corp
Detroit, MI4 days ago- ...Medicare Strategy Location: Remote Position Overview This role provides... ...strategy, and regulatory compliance. The position is responsible... ...other government-sponsored health plans. Collaborate with product management... ...function Finance Industries Claims Adjusting, Actuarial Services...Remote workClaimsHealth InsuranceFull timeWork at office
Selby Jennings
New York, NY1 day ago $20 - $21.5 per hour
SHPCA SCAN Health Plan is seeking a Bilingual Member Service Advocate... ...Korean, or Vietnamese for a remote position. The role involves acting... ...benefits, eligibility, and claims. The ideal candidate will... ...resolving inquiries, and ensuring compliance with regulations. This...Remote jobClaimsHealth InsuranceHourly pay$80k - $94k
...that may disrupt their plans. Travel Guard became part... ...inquiries and compliance-related matters Review... ...nurses, case managers, claims specialists, finance experts... .... Investing in your health and your future. We offer... ..., IL (preferred) or Remote The compensation indicated...Remote workClaimsHealth InsuranceContract workTemporary workWork at officeWork from homeWorldwideZurich Insurance Group
Schaumburg, IL10 hours ago- ...position requires knowledge in healthcare and compliance, with strong experience in medical claims and investigations. Candidates should have a... ...comprehensive benefits package that includes health insurance, 401K, stock plans, tuition reimbursement, and generous paid time...Remote jobClaimsHealth InsuranceFlexible hours
$93.8k - $122k
...workers’ compensation claims management within a high... ...on return-to-work planning, accommodations, and claim... ..., and related compliance activities* Coordinate... ...benefits program includes health benefits, retirement plan... ...relocation or remote work arrangements outside...Remote workClaimsHealth InsuranceWork experience placementH1bWork at officeRelocationRelocation packageDonaldson Aerospace & Defense
Bloomington, MN4 days ago- ...Actuarial Analyst ALDP - Remote role at... ...we're simplifying the health care experience, creating... ...and removing barriers to quality care. The work you do here... ...functionally with health plan market leadership, forecasting... ...information, trends, claims experience, and eligibility...Remote workClaimsHealth InsuranceWork experience placementInternshipLocal area
UnitedHealthcare
Minnetonka, MN2 days ago $120k - $135k
About Judi Health Capital Rx, a public benefit corporation... ..., TPAs, and health plans, and Judi®, the... ...which consolidates all claim administration-related... ...secure platform. Location: Remote (For Non-Local) or Hybrid... ...deliverables, ensuring compliance with federal and state...Remote workClaimsHealth InsuranceLocal area$61.3k - $73k
...transparency, and efficiency to health plans. Deployed by over 75... ...‑leading speed, quality, and accuracy. We're... ...eligibility, healthcare claims, eligibility... ...inventory to validate compliance with internal requirements... ...in a hybrid or fully remote setting, access to reliable...Remote workClaimsHealth InsuranceFor contractorsWork at officeWork from homeHome officeShift workThe Rawlings Group
New York, NY1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Health Plan Quality Auditor - Claims & Compliance. Be the first to apply!
Related searches
- quality review specialist California, MO
- quality specialist California, MO
- quality control associate California, MO
- warehouse quality control associate California, MO
- quality assurance auditor California, MO
- quality systems specialist California, MO
- quality system auditor California, MO
- quality auditor California, MO
- quality improvement specialist California, MO
- quality management specialist California, MO