Claims Auditor
Community First Health Plans
POSITION SUMMARY/RESPONSIBILITIES
Responsible for development and maintenance of claims auditing program for all lines of business to improve claims processing standards and to monitor the quality of service delivered to our customers. Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid programs and knowledge of CFHP claims payment processing system, Amisys.EDUCATION/EXPERIENCE
High school diploma or equivalency is required. Minimum of five years experience in insurance, medical or managed care environment including two years of claim processing experience required. Previous auditing and/or Amisys experience preferred. #J-18808-Ljbffr Community First Health PlansVacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Claims Auditor in San Antonio, TX vacancy
$70k - $80k
W.R. Berkley in San Antonio is seeking a Stop Loss Claims Auditor to evaluate claim submissions for reimbursement eligibility. You will review claims, maintain accuracy, and apply relevant contractual provisions. The ideal candidate has 3-5 years of stop loss claims experience...ClaimsRemote job$70k - $80k
Stop Loss Claims Auditor As a Stop Loss Claims Auditor (a.k.a. "Claims Analyst"), you'll perform quality review and evaluation of all claim submissions received and logged into our claims system to determine whether the amount requested is eligible for reimbursement....ClaimsFull timeWork at officeRemote work$70k - $80k
Berkley Accident and Health, based in San Antonio, Texas, is seeking a Stop Loss Claims Auditor. In this role, you will evaluate claims submissions to determine eligibility for reimbursement. The position offers a hybrid schedule for your convenience, allowing flexibility...ClaimsRemote jobWork at office- Berkley Accident and Health is hiring a Stop Loss Claims Auditor to review and evaluate claim submissions, ensuring eligibility for reimbursement. The role supports a hybrid work model with remote possibilities and offices in multiple states. The candidate should have...ClaimsRemote job
$70k - $75k
...Best Workplaces in Financial Services & Insurance Attorney Auditor ** This is a fully remote position, and candidates residing... ...this or other roles. Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating...ClaimsLocal areaRemote workWork from homeFlexible hoursSedgwick
San Antonio, TX3 days ago$52.73k - $79.1k
Under general supervision, participates with other auditors in performing financial, contract compliance, grant, and performance/operational... ...will be needed for employment verification. Applicants claiming military service to meet the experience requirement for this position...ClaimsFull timeContract workCasual workWork at officeLocal areaMonday to FridayFlexible hours$57k
...Pharmacy Claims Auditor CPhT Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count...ClaimsWork at officeLocal areaRemote workWork from homeFlexible hoursNight shift- A health plans organization in San Antonio is seeking a Claims Auditor to manage and enhance their claims auditing program. The role involves overseeing claims processing standards and ensuring high-quality service delivery to customers. Candidates should have at least...Claims
$100k
Join to apply for the Premium Field Auditor (Hybrid) role at Brown & Joseph AR Management | an ARMStrong IS Company 2 days ago Be among... ...LEADER-R&D - MANAGER-R&D - Quality Systems & Auditing Complex Claims Consultant - Architect & Engineer Liability GROUP LEADER-R&D -...ClaimsWeekly payFull timePart timeLocal areaImmediate startRemote workWork from homeHome office2 days per week3 days per week- Claims Auditor Community First Health Plans University HealthClaims
- ...Health is seeking a dedicated and detail-oriented Senior Integrity Auditor to join our Compliance team. This pivotal role is responsible... ...areas such as coding, billing, medical record documentation, claims, and clinical data. - Routinely review University Health’s revenue...Claims
- ...Independent Insurance Claims Adjuster (Licensed) Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity...Claims
MileHigh Adjusters Houston
San Antonio, TX4 days ago - ...such as co-pays and deductibles, and generating reports for all of these activities. Duties may also require follow-ups on denied claims, daily insurance claims, and posting payments made by patients to their account. • You will have to solve collection and registration...Claims
World Pediatric Dental
San Antonio, TX4 days ago - ...Role Summary Performs a variety of AR activities and related tasks in order to recognize the maximum reimbursement from each claim. This position will be responsible for navigating the electronic medical record (EMR) and billing systems to obtain/produce and transmit the...ClaimsWork at office
Mpower Health
San Antonio, TX3 days ago $19 per hour
...Reimbursement Specialist to join our healthcare team. The ideal candidate will be responsible for managing and processing medical claims, ensuring accurate reimbursement from insurance providers, and maintaining compliance with healthcare regulations. This role requires...ClaimsFull timeWork at officeTsaog Orthopaedics and Spine
San Antonio, TX1 day ago- ...Head of Claims About the Company Growing specialty insurance organization focused on claims strategy and operational excellence. Industry Insurance Type Privately Held About the Role The Company is seeking a Head of Claims to take on a senior leadership...Claims
- ...operations within a healthcare environment. This position is responsible for ensuring accurate billing, maximizing reimbursement, managing claims processing, resolving denials, and maintaining timely collections across multiple payer types. The ideal candidate will have...ClaimsWork at office
Peyton Resource Group
San Antonio, TX4 days ago - ...adjusting experience is required for career-entry applicants. Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained...ClaimsFlexible hours
MileHigh Adjusters Houston
San Antonio, TX3 days ago - Independent Insurance Claims Adjuster (Licensed) Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity...Claims
- SWBC in San Antonio, TX seeks a seasoned supervisor to oversee mortgage claim processing. You will guide a team, resolve complex claims, and ensure accuracy, compliance, and excellent customer service. In this hands-on role, you’ll train staff, optimize workflows, and act...Claims
- ...seeking motivated individuals for a career in Dental Revenue Cycle Management. You'll receive extensive training in dental insurance claims processing, paving the way for advancement into roles such as Dental Claims Specialist or Account Manager. The ideal candidate is...ClaimsFlexible hours
- ...denials, insurance follow-ups, and appeals based on their tier level in a hospital setting. Ensures accurate and timely submission of claims, works to resolve outstanding balances, and communicates effectively with insurance companies to maximize reimbursement....Claims
UT Health San Antonio
San Antonio, TX2 days ago - ...and committed candidates are encouraged to apply. Role Description This is a full-time on-site role for a Commercial Transportation Claims Adjuster located in the San Antonio, Texas Metropolitan Area, or hybrid in Dallas or Houston. The Commercial Transportation Claims...ClaimsFull timeContract work
- GPM Life Insurance in San Antonio, TX is seeking a Claims Examiner‑Contestable to review, process, and pay life insurance or annuity death claims issued within the last two years. This is an in-office, full-time position with a focus on accuracy and compliance with company...ClaimsFull timeWork at office
- ...experienced Content Writer for a 6-month remote contract. The ideal candidate has a strong background in Property & Casualty insurance and claims, focusing on creating clear and compelling content for digital claims experiences. This role involves collaborating with cross-...ClaimsRemote jobContract work
- GOVERNMENT PERSONNEL MUTUAL LIFE INSURANCE COMPANY is seeking a Full-Time Claims Examiner-Contestable in San Antonio, TX. The role involves review and processing of life insurance claims issued within the last two years, ensuring compliance with company policies. Candidates...ClaimsFull time
- ...for a leadership role in our San Antonio office. The position requires at least 5 years of experience adjusting property insurance claims and a minimum of 3 years in a supervisory capacity. The candidate will guide a team of adjusters, manage escalated issues, and ensure...ClaimsWork at office
$60k - $90k
...customer accounts and update information in the database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters to ensure timely policy issuance. Qualifications...ClaimsFor contractorsFlexible hoursPeter J Story - State Farm Agent
San Antonio, TX1 day ago- ...not, obtains them. Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program parameters. Provides...ClaimsExtra incomeFreelanceWork at officeRemote work
Dane Street
San Antonio, TX4 days ago - We have an immediate opening for an experienced Property Claim Supervisor. Candidate must have excellent leadership and supervisorial skills with the ability to guide and develop a team of adjusters. The candidate must possess excellent writing skills. Must understand...ClaimsWork at officeImmediate start
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Auditor. Be the first to apply!
Related searches
- sales auditor San Antonio, TX
- remote nurse auditor San Antonio, TX
- inventory auditor San Antonio, TX
- coding auditor San Antonio, TX
- medical records auditor San Antonio, TX
- remote auditor San Antonio, TX
- security auditor San Antonio, TX
- safety auditor San Antonio, TX
- field auditor San Antonio, TX
- medical claims auditor San Antonio, TX