Quality Audit Analyst II - Medicare/Medicaid Claims
Hispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement in Boston is seeking a dedicated professional to excel in Medicare and Medicaid High Dollar claim processing. The role emphasizes quality audits and a commitment to exceeding client expectations in a hybrid work environment. Qualified applicants will have at least one year of relevant experience, strong analytical and communication skills, and a focus on continual improvement. Interested candidates can expect support through comprehensive benefits that ensure both physical and financial well-being. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$24.5 - $26 per hour
...Carrington in Boston, Massachusetts is seeking a Default FHA Claims QA Analyst II to review FHA mortgage insurance claims for accuracy and ensure compliance with regulations. This remote position offers a target pay of $24.50/hr - $26.00/hr. The ideal candidate should...ClaimsRemote work$24.5 - $26 per hour
...our amazing team and work remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for... ...accuracy within the investor/insurer timeframes. Complete quality checks using a scorecard and/or checklist to identify errors...ClaimsRemote workWork from home- ...Government Programs Actuarial Analyst II position will serve as... ...matter expert for the Medicare and Dual Eligible... ...reporting to monitor claims and risk score trends,... ...annual external audits, DOI audits, and recurring... ...concepts, deliver high‑quality work, and ensure...ClaimsFull timeWork at officeMonday to FridayFlexible hours
- ...This includes making decisions on abatement claims, resolving disputes, and working with... ..., professional experience in accounting, auditing or tax examining work, or (B) any equivalent... ...of Revenue Title: Tax Examiner II Location: Massachusetts-Boston-100...ClaimsFull timePart timeWork experience placement
$21.1 - $49.08 per hour
...accountable and prioritize safety and quality in everything we do. Join us... ...for Aetna performs quality audits for service operations for... .... Government Programs Claim Quality is an exciting and... ...SOX and Sarbanes control for Medicare and Medicaid Claim Processing. We are looking...ClaimsHourly payFull timeWork at officeLocal areaFlexible hours3 days per week- ...Claims Specialist II Job Locations: US-TX-Plano; US-MA-Boston; US-NV-Las Vegas; US-GA-Suwanee; US-AZ-Chandler; US-OR-Lake Oswego; US-IN-Indianapolis; US-IL-Hoffman Estates; US-CT-Weatogue The Claims Specialist works within a Claims Team, using the latest technology to...ClaimsWork experience placementWork at officeRemote work
- ...A leading IT staffing company is seeking a Quality Control Analyst II to perform essential operations for quality testing and implement new technologies in quality control. The candidate should have 3 to 6 years of experience and will be responsible for routine testing...Contract work
- ...Quality Control Analyst II (JOB ID- 4903049) Contract Artech is the 10th Largest IT Staffing Company in the US, according to Staffing Industry Analysts' 2012 annual report. Artech provides technical expertise to fill gaps in clients' immediate skill-sets availability,...Contract workImmediate start
- ...functions related to the collection of necessary claim documentation, claim submission,... ...resolve outstanding claims issues as needed. Audit file submissions and work through any... ...and cost shares. Experience working with Medicaid, private insurance, insurance verification...ClaimsHourly payRemote workFlexible hours
- ...Insurance Underwriting Association is looking for an Examiner II to join our Claims department. This position reports to the Property Claims... ...Adjusters. Assists in the semi-annual Claims Department Reserve Audit. All other duties and projects as assigned....ClaimsWork at officeLocal area
- ...Supervisor to lead the Medicaid Management Information... ...Provider Reimbursement and Claims Business Analysis team... ...Reimbursement Business Analyst Team Supervisor . The... ..., development support, quality assurance testing, implementation... ...required experience. II. A Bachelor’s degree or...ClaimsFull timePart timeFor contractors
- ...Liberty Mutual is looking for a Claims Specialist II based in Boston, MA. This hybrid position involves managing claims using advanced technology and requires evaluating liability and negotiating settlements. Candidates should have a BS/BA degree and minimum 2 years of...ClaimsRemote work
- ...The Massachusetts Property Insurance Underwriting Association (MPIUA) is seeking an Examiner II to join its Claims department in Boston. This role is crucial for ensuring proper processing and evaluation of property claims. The successful candidate will need a college...Claims
- ...Summary We are seeking an experienced IT Quality Assurance professional to support complex... ...and cases Collaborate with business analysts to understand requirements and with... ...in commercial insurance underwriting or claims systems Experience with enterprise policy...Claims
- ...Liberty Mutual is seeking a Technical Claims Specialist II to investigate and manage claims, ensuring compliance with coverage provisions. The candidate should have strong writing skills and a solid understanding of General Liability and Business Auto claims handling....ClaimsRemote work
$90k - $120k
Product Delivery Manager (Healthcare - Medicaid & Medicare) Join to apply for the Product Delivery... ...transformation journeys that enhance care quality and administrative performance. Cross-... ...care, eligibility & enrollment, and claims administration. Proven ability to lead...ClaimsFull timeRemote workFlexible hours$60k - $62k
Arbella 56 Group in Quincy, MA is seeking a Claims Service Specialist II to join the General Liability Team. In this role, you will investigate and resolve first and third party claims while ensuring excellent customer service and teamwork. The ideal candidate has 1-2...Claims- ...Alan Gray LLC is a leading audit and advisory firm with over 30 years of excellence in... ...support projects and engagements. Claims Auditor: The claim auditor will review... ...ability to prioritize. Demonstrated focus on quality and continuous improvement....ClaimsTemporary work
- ...Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other... ...high level of accuracy and quality in coding assignments to ensure... ...reimbursement and minimize claim denials. -Utilize coding... ...by participating in coding audits, internal or external coding...Claims
$56.96k - $89.71k
...Audit and Reimbursement II Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training... ...programs. The organization delivers solutions across claims administration, data, and care delivery to help address complex...ClaimsFull timeTemporary workWork experience placementInterim roleWork at officeLocal area1 day per week$65.07k - $91.77k
...The Commonwealth of Massachusetts is seeking a Job Service Rep II in Boston. This long-term seasonal position involves overseeing a team and ensuring claims integrity within the Department of Family Medical Leave. The ideal candidate should have at least three years of...ClaimsSeasonal workWork at office1 day per week$71.2k - $158.2k
...following: Federal Reporting Understand Medicare data, data design, and relationships pertaining to the member, provider, and claim Create novel and standard insightful... ..." analytic designs for Medicare and Medicaid solutions Partner with data scientists...ClaimsTemporary workWork experience placementFlexible hours$65.52k - $86k
...Hi, we’re Oscar. We’re hiring an Analyst II, Actuarial to join our Actuarial team. About the role The Analyst II, Actuarial maintains Oscar... ...for the accrual setting process with respect to IBNR claims, Risk adjustment and Shared Savings deals. Identify and triage...ClaimsWork at officeRemote work- ...Treasury Operations Analyst, US Department: Finance Employment Type: Full Time Location:... ...to support day‑to‑day cash operations and claims‑related financial processes within a specialty... ...activities, including 1099 processing, audits, and internal controls. Process accounts...ClaimsFull timeRemote workFlexible hours
$87.5k - $130.6k
...ASSISTANT ATTORNEY GENERAL HEALTH CARE & FAIR COMPETITION BUREAU MEDICAID FRAUD DIVISION Attorney General Andrea Joy Campbell is seeking... ...civil litigation, health care fraud litigation, and False Claims Act litigation preferred. Excellent oral and written advocacy skills...ClaimsFull timeWork at office$136.5k - $210k
...Posting Description Account Executive II - Boston Are you looking to be a member of an industry-leading team? Do you want to deliver... ...resources to support clients in unusual circumstances such as large claims, etc. Involves others across geographic (including international)...ClaimsWork at officeLocal area$83.25k - $130.55k
...Telephonic Nurse Case Manager II Location: This role enables associates to work virtually full-time, with the exception of required... ..., as applicable. Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care...ClaimsFull timeWork at officeLocal areaMonday to FridayAfternoon shift$60k - $62k
...Claims Investigator Under frequent supervision, investigate and resolve first and third party material damage, PIP and BI claims which... ...experience will assist in the training of Claims Service Specialists II and below. Performs other related duties as required or...ClaimsLocal area$87.5k - $130.6k
...Joy Campbell is seeking a highly motivated attorney to join her Medicaid Fraud Division as an Assistant Attorney General to handle... ...complex civil litigation, health‑care fraud litigation, and False Claims Act litigation preferred. Excellent oral and written advocacy skills...ClaimsFull timeWork at officeRemote work$33.65 - $38.46 per hour
...Quality Control Scientist At Vericel Corporation, we are pioneers in advanced cell therapies for sports medicine and severe burn care... ...laboratory housekeeping and preparation of the laboratory for audits. Participate in training of less experienced staff....Hourly payFor contractorsWork at office
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