Senior Claims Researcher AI-Driven Audit & Accuracy
Clover Health
Clover Health, LLC is seeking a highly analytical Senior Claims Researcher to join the Claims Excellence team. In this role, you will perform deep-dive research and quality audits to ensure claims accuracy. You will collaborate with stakeholders and support the implementation of AI auditing tools. With 5+ years in Medicare Advantage claims, you will utilize your technical skills to drive payment precision. Clover prioritizes employee well-being with comprehensive benefits, a remote-first culture, and professional development opportunities. #J-18808-Ljbffr
- ...works: we embrace AI as a core productivity... ...culture is driven by our values and continuous... ...under license. Claim based on GitLab data... ...of this role As a Senior Manager, Revenue... ...helping the team improve accuracy, support compliance... ...reporting and audit readiness. In your...SeniorClaimsContract workRemote work
- ...The Phia Group is looking for a Senior Software Engineer to join their team and take on the challenge of designing and building applications... ...healthcare-related workflows. This remote position emphasizes AI-enabled development, focusing on improving software delivery and...SeniorClaimsRemote work
$110k - $130k
...Role Second Nature is seeking a senior, strategic leader to take... ...managing direct reports, overseeing claims operations, and building... ...accurately documented to support audit and compliance readiness. Customer... ...discussions with data‐driven insights and recommendations....SeniorClaimsRemote work$50 - $60 per hour
...A legal research firm in New Jersey is seeking a Legal Researcher to improve AI models by providing complex legal problems and assessing their outputs. Candidates must have a law degree and at least 5 years of legal experience. The position offers flexible scheduling,...SeniorHourly payRemote workFlexible hours- ...Job Title: Senior Data Analyst Location: Remote Reports To: SVP, Data... .... Whether you’re pulling claims data, building dashboards, or... ...business questions into data-driven answers. Analyze structured healthcare... ...data culture that prioritizes accuracy, transparency, and business...SeniorClaimsRemote work
$202k - $278k
...in large-scale production systems and expertise in distributed systems and AI-driven extraction. This role focuses on reducing human dependency in validation processes while ensuring accuracy and scalability. The firm offers competitive compensation with a salary range...- ...Senior Software Data Engineer As a Senior Software Data Engineer,... ...building on a Message Bus (event‑driven systems, pub/sub, messaging... ...RCM) domains such as billing, claims, eligibility, payments, denials... ...openness to innovation including AI to explore better processes...SeniorClaimsTemporary workWork at officeRemote work
$211.55k - $317.33k
...leading healthcare technology firm in the United States is seeking a Senior Medical Director. This pivotal role involves providing strategic... ...range of $211,551 to $317,326 annually. Join us in shaping the future of healthcare with innovative AI solutions. #J-18808-Ljbffr...SeniorClaims- ...digital transformation. As AI and cloud drive the demand for... ...the world for good. Driven by purpose and fueled by a spirit... ...Impact You Will Have: The Senior Development Project Engineer (... ...complaint or discrimination claim. The "Know Your Rights" Poster...SeniorClaimsFor contractorsWork at office
- ...close activities. The Experienced Senior Accountant will support... ...support loss reserve analysis and claims data reconciliation. Assist... ...supporting documentation for audits and tax filings. Assist in... ...engagements. Ensure quality, accuracy, and timeliness of...SeniorClaimsWork experience placementLocal areaFlexible hours
- ...Overview As a leading AI company generating over... ...insurance, our work spans claims document processing,... ...and improve underwriting accuracy. Position Overview... ...sector, you will be the senior commercial and strategic... ...identify opportunities for AI-driven transformation across...Claims
- ...digital transformation. As AI and cloud drive the demand for... ...the world for good. Driven by purpose and fueled by a spirit... ...Impact You Will Have: The Senior Development Project Manager... ...any complaint or discrimination claim. The "Know Your Rights"...SeniorClaimsFor contractorsWork at office
- ...Thrive Global is seeking a Senior Customer Success Manager to oversee customer relationships... ...manage a defined portfolio, utilizing AI to enhance workflows and customer interactions... ...is essential, along with a mission-driven mindset. This role offers competitive compensation...Senior
$102.5k - $187.9k
...Technical Consultant – Senior EY is a leader in serving... ...today, such as in claims, underwriting, policy and... ...a proven ability to research client inquiries and... ...demand, performance- driven environment. In addition... ...markets. Enabled by data, AI and advanced technology...SeniorClaimsWork experience placementSummer holidayFlexible hours$216.42k - $324.63k
...Lyric, an AI-first healthcare technology company, is seeking a Clinical Ambassador. This full-time role involves engaging with payer... ...where success is shared. Candidates should have an understanding of claims operations and payment integrity programs. #J-18808-Ljbffr...SeniorClaimsFull time- ...Senior Research and Operations Executive (healthcare market research) Remote-based This is... ...and data sciences. Our global insights-driven approach empowers pharmaceutical brands... ...data review and management processes with accuracy and attention to detail. Work...SeniorWork at officeRemote workWork from homeShift workNight shift
$136.3k - $273.9k
...collaborating with various teams. Candidates should have deep technical expertise and experience with performance optimization and AI-driven tools. The position offers a competitive compensation range of $136,300 to $273,900 based on location and experience. #J-18808-...Senior- ...A leading family-focused technology company is seeking a Senior Manager for Search Innovation to drive its organic search strategy.... ...scalable content systems and optimizing for both traditional and AI-driven search. The ideal candidate will have 6 to 9 years of hands-on...SeniorFull timeTemporary work
- ...Healthmark Group is hiring a Senior Software Engineer - AWS to lead the design and development... ...position leads a small team, emphasizing AI-assisted development and directly... .... Healthmark values contributions and promotes a results-driven culture. #J-18808-Ljbffr...SeniorRemote work
$85.39k - $116.98k
...is seeking a talented Senior Systems Engineer (Amazon... ...services and event-driven architectures to process... ...ability to evaluate when AI-assisted code generation... ...around healthcare data accuracy and fidelity ~... ...Interchange X.12 (EDI) Medical Claims ~ X.12, Medical...SeniorClaimsFull timeRemote work- ...candidates have over 4 years of backend experience, strong Ruby on Rails skills, and PostgreSQL expertise. Enjoy end-to-end ownership in an AI-driven environment with flexible paid time off, wellness reimbursements, and a competitive stock option grant. #J-18808-Ljbffr...SeniorFlexible hours
- ...A sports technology company in the United States is seeking a Senior Software Engineer to develop backend systems for high school sports... .... This role demands strong expertise in C# .NET, SQL, and AI-driven development workflows. The ideal candidate will have over 5 years...Senior
$205k - $270k
...platform combines the best of AI and human intelligence to help... ...ability to translate cutting-edge research into scalable, production-... ...measurable quality metrics (e.g., accuracy, faithfulness, task completion... ....ai domain. Any outreach claiming to be from Cresta via other sources...SeniorClaimsContract workFor contractorsFor subcontractorWork at officeRemote workHome officeFlexible hours$178.3k - $407k
...build a better working world. AI & Data, Advanced Analytics - Health Sector – Senior Manager - Consulting We are helping... ...and unstructured data (e.g. EHR, claims, ERP, financial, RWE, supply chain) to drive high-quality, data-driven business decisions and measurable...SeniorClaimsWork experience placementSummer holidayFlexible hours- Description Position Description The Senior Teammate Relations Specialist will serve... ...reports, including semi-annual Board Audit Committee reports, weekly and monthly teammate... ...related decisions, such as unemployment claims. Identify policies and procedural gaps...SeniorClaimsWork experience placement
$80k - $150k
...Senior Auditor Employment Type: Full Time, Mid-level Department: Financial Services CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and...SeniorClaimsFull timeFlexible hours$140k - $160k
...technology and data-driven commercial MGA and... ...experience, data, and AI/ML to optimize the... ...Job Summary The Claims Manager position at... ...reports to the Senior Vice President of Claims... ...payments to ensure accuracy, timeliness, and... ...Conduct internal audits on a quarterly basis...ClaimsTemporary workLocal areaRemote workWork from home$120k - $140k
...industry, is seeking a motivated, self-starting Senior Data Analyst to join the Finance team.... ...a purpose-built EMR, billing and claims management, and patient acquisition and engagement... ...and have an investigative mindset — driven to know “why” Ability to think critically...SeniorClaims$27.64 - $38.03 per hour
...Horace Mann is seeking a Group Claims Examiner in the United States to manage and analyze claims in Group Insurance. The ideal candidate... ...responsibilities include reviewing claims for compliance and accuracy, providing excellent customer service, and supporting...ClaimsHourly pay$65 per hour
...Senior Epic Systems Analyst (Resolute Hospital Billing) Senior Epic Systems Analyst (Resolute Hospital Billing) Get AI-powered advice on this job and more exclusive features. iMethods is... ...Security; Resolute Hospital Billing Claims; Resolute Hospital Billing Electronic...SeniorClaimsFull timeCasual workWork at officeRemote workShift work
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