Clinical Editing & Claims Dispute Analyst - Remote
Jobrapido
- Remote job
Jobrapido is seeking a Clinical Editing Dispute Review Analyst 1 to research, review, and resolve clinical editing inquiries, claims disputes, and appeals. You will collaborate with Medical Directors, Claims, Provider Services, and external vendors to ensure accurate claims processing and timely provider reimbursement. You will coordinate with multiple stakeholders, track inquiries, monitor turnaround times, and help prepare weekly metrics while maintaining compliant documentation. #J-18808-Ljbffr Jobrapido
- ...Resolute Professional Billing and Claims Analyst to support the implementation... ...effectively in a primarily remote consulting environment.... ...routing, claim generation, claim edits, and claims processing... ...Experience collaborating with clinical, operational, and financial stakeholders...Remote workFull timeLive inFlexible hours
$18.5 - $38.82 per hour
...time. A Brief Overview Inspects and provides accurate claim information to support savings optimization for claims.... ...distribution of tasks to appeal nurses Reviews provider coding edits routed from non-clinical claims and prepares them for review by an Aetna clinician....Remote workHourly payFull timeWork experience placementLocal area- ...PA with the opportunity for remote or hybrid remote work,... ...preferred. CPC required The Claim and Denial Coding Analyst role is a Certified Medical... ...Charge Review and Claim Edit CCI/LCD edits, diagnosis coding... ...appeal rationale based on clinical documentation, application...Remote workLocal areaFlexible hours
- ...measurable value, reduced waste, and improved clinical outcomes. With unmatched scientific... ...in this document. About the Claims Editing Analyst, GTM Position: The Claims Editing Content... ...rules. This position is eligible for remote work, but quarterly travel will be required...Remote workWork experience placementWork at officeFlexible hours
- Lyric, a leader in healthcare decision intelligence, seeks a Clinical Analyst to support clinical policies and payment solutions for fast, accurate coverage decisions. You will interpret diagnostic testing insights, IT data, and payment rules to drive automation and transparency...Remote job
- ...across Texas facilities, focusing on outpatient coding edits, NCCI, and medical necessity. You will resolve... ...audits while collaborating with HIM, Revenue Cycle, and clinical teams to ensure compliant, timely claim submissions. This role demands advanced ICD-10-CM/CPT...
$41.45 - $59.58 per hour
...Epic Resolute Certified Analyst to support our... ...supports external partner clinics using UNC Health's Epic... ...professional billing (PB), claims management, and end-to-... ...Morrisville, NC (Hybrid: Remote & Onsite) Team:... ...charge routing, claim edits, payer setup, and workqueues...Remote workHourly payFull time$45 per hour
...Healthcare Staffing seeks a detail-oriented Clinical Editor to work remotely in New York. This position, which requires an... ...License, combines clinical expertise with editing skills to ensure the accuracy of healthcare dispute resolutions. Responsibilities include reviewing...Remote job- ...Employees' Credit Union (SECU) seeks a Fraud Dispute Specialist to support members by... ...union. You will investigate routine fraud claims, review documentation, and process credits... ...reversals while maintaining audit-ready records. Remote/hybrid work options may be available...Remote job
$48.3k - $65.9k
...of our caring community Code Edit Disputes team reviews and educates providers... ...is a dispute on adjudicated claims that contain a code editing... ...Coding Coordinator extracts clinical information from a variety of... ...knowledge. This is a remote position from anywhere in the...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$43.68k - $47.84k
...Step Into a Rewarding Role as a Claims Specialist with PharMerica!... ...to advance their careers. Remote Flexibility : This position is... ...by performing appropriate edits and/or reversals to ensure maximum... ...compliance with best-in-class clinical standards. We are committed to...Remote workFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work$174k - $196k
...Associate Director, Clinical Pharmacology Remote Associate Director, Clinical Pharmacology City Therapeutics is advancing a next-generation platform... ...oligonucleotide therapeutics, i.e. siRNA, antisense, gene editing, or other nucleic acid-based modalities. Compensation The...Remote workWork at officeWork from homeFlexible hours- ## Claims Examiner IIApply: Work at Home - Nebraska: Full time: Posted... ...system’s claim and line item edits for determination of whether... ...**Candidates applying to this remote position are required to live... ...independently.* Review claim disputes submitted by member and providers...Remote workFull timeContract workLive inLocal areaWork from home
$45 per hour
Clinical Editor (Remote) Location: New York, NY (Remote) Job ID: #25206 Employment Type: Full‑time... ...accuracy and clarity of healthcare dispute resolutions. Why You Should Apply Competitive... .... Key Responsibilities Review and edit dispute resolutions using checklists...Remote jobHourly payFull timeContract workMonday to Friday$110k
...We review high-dollar claims before they are paid, reprice... ...pricing using APC Clinical review of inpatient and... ...billing rules, claim edits, and payment integrity... ...Philadelphia area preferred, but remote work is possible for a... .... As our Senior Claims Analyst, you will build the...Remote workFull timeTemporary workWork at officeWork from home2 days per week- ...Apply working knowledge of medical terminology and coding principles in re-pricing claims and complete assignments meeting quality assurance goals. Implement, terminate, and track pre-pay edit requests daily, and prepare monthly prepay saving reports. Requirements:...Remote jobDaily paid
- ...Candidates applying to this remote position are required to live... ...Responsibilities Adjudication of healthcare claims utilizing employer and payer... ...system's claim and line item edits for determination of whether... ...independently. Review claim disputes submitted by member and...Remote jobContract workLive inLocal area
- US Remote Job Description Get To Know Us! WebTPA, a GuideWell Company, is a healthcare... ...Time for 4 weeks What is your impact? As a Claim Examiner, you will handle processing and... ...and coverage under policy guidelines (clinical edit logic). Incumbents are expected to meet...Remote jobTemporary workPart timeWork experience placementMonday to FridayFlexible hours
- ...working supervisor who leads a remote team of clinical auditors performing medical... ...a limited volume of SNF claim reviews; serve as technical... ...escalation point for complex or disputed cases, including skilled... ...codes, and consolidated billing edits. Experience...Remote workFull timeFor subcontractorWork at office
- ...Description Location : Remote (Candidates must reside... ...Description: The Claims Specialist II – Provider... ...and processing provider disputes in accordance with... ...and price complex claim edits across all claim types... ...partner specializing in clinical & operations management...Remote workWork at officeImmediate start
$110.5k - $150k
...payment integrity provider disputes and escalations to... ...support teams to ensure edits, audits, and reviews are... ...compliance across all claim disputes and escalations... ...: Collaborate across clinical, coding, and operational... ...accuracy. #LI-DS1 #LI-Remote Salary range: $110,...Remote workFull timeContract workInternship- EmblemHealth Remote position seeks a Health Care Claims Data Analyst to develop business requirements for queries that analyze vendor payment data and to leverage post-claim editing and recovery programs. You will analyze claims, payments, and vendor data to identify overpayments...Remote job
- ...Claims Dispute Resolution Analyst Under the supervision of the Manager of Health Fund Operations, the Claims Dispute Resolution Analyst will be... ...to our members and identify resolution pathways. Analyze clinical documentation to support or contest payment disputes....Work at office
- Guardian Life is seeking an RN Clinical Consultant to support disability claim evaluations. You will review medical information, assess functional capacity... ..., and case managers. Based in the United States with remote options, you will manage a high-volume workload while...Remote job
- ...We're looking for an experienced Lead Clinical Data Manager to take ownership of clinical... ...lock. Oversee eCRF design, EDC systems, edit checks, UAT, data cleaning and reconciliation... .... Ability to work independently in a fast‑paced, remote environment. #J-18808-Ljbffr...Remote work
- ...sciences organisation to recruit multiple Lead Clinical Data Managers to support clinical trials... .... Oversee eCRF design, EDC setup, edit checks, UAT, data validation and query management... .... Why Consider This Opportunity? Fully remote working arrangement. Opportunity to take...Remote work
$80 per hour
...Clinical Data Manager (Contract - W2) - 18 Months Location: Remote US Only Max pay rate : $80/hour (Est 165k on an annualized basis) Our client, a precision medicine... ...cleaning to timeline. Support eCRF build and testing, edit checks, validation rules, and UAT. Build and...Remote workContract workFor contractorsInterim role- ...marketing efforts for the Association for Clinical Pastoral Education (ACPE) while also... .../ Meeting Planning: Oversees the design, edits, and drafts for print and digital media for... ...of GA. Emory reserves the right to change remote work status with notice to employee. Additional...Remote workWork from homeFlexible hours
- ...practice in Atlanta, GA is seeking a Licensed Clinical Psychologist with strong experience... ...psychometrists, interpreting assessment results, and editing and finalizing comprehensive... ...reports. Position Highlights: Fully remote Full-time or part-time opportunities Compensation...Remote workFull timePart timeFor contractorsPrivate practice
- ...well established CRO seeking an experienced Clinical Data Coordinator to join their growing... ...collaborative, supportive environment, fully remote. Key Responsibilities: Support day to day... ...), including review of CRF/eCRF designs, edit check specifications and completion...Remote workInterim role
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