Payment Integrity Lead — Fraud & Compliance (Remote)
Centene Corporation
- Remote job
Centene Corporation is seeking to hire a dedicated professional to develop and manage strategic fraud, waste, and abuse activities. The role involves leading a team to ensure compliance with billing and claims processes while developing educational materials and fraud plans tailored to contractual requirements. The ideal candidate will possess a Bachelor’s degree and at least 4 years in medical claim investigation, with a strong knowledge of medical terminology and data analysis. A comprehensive benefits package is included, promoting a flexible working approach. #J-18808-Ljbffr Centene Corporation
- ...Corporation in the Town of Florida, NY is seeking a Fraud Investigation Manager to oversee strategic... ..., and abuse activities. This role involves leading analyst teams, developing educational materials, and ensuring compliance with state and federal requirements. The...Remote jobFraudFlexible hours
$101.23k - $172.36k
...PAYMENTS FRAUD ANALYTICS LEAD WHAT IS THE OPPORTUNITY? The Payments Fraud Analytics Lead leads the Bank... ...for entrepreneurs and that legacy of integrity, community and unparalleled client relationships... ...Unless otherwise indicated as fully remote, reporting into a designated City...Remote workFraudFlexible hours- Commence seeks a Healthcare Program Integrity Solutions Consultant to enhance commercial... ...The role demands expertise in healthcare fraud, payment integrity operations, and the ability... ...position offers a competitive salary, and remote opportunities are available in many...Remote workFraud
- A leading fintech company is seeking an experienced Business... ...technical execution, ensuring compliance and optimal performance.... ...specifications for API integrations, and defining fraud management procedures. The... ...requires at least 5 years in payments analysis, specializing in...Fraud
- DOMA Technologies is seeking a Payment Integrity Expert to enhance healthcare outcomes and operational... ...operations, with a strong focus on fraud prevention and auditing within... ...work arrangements, combining office and remote responsibilities. #J-18808-Ljbffr DOMA...Remote jobFraudWork at office
- About the Role The Lead Risk Analyst will... ...risk management and fraud prevention efforts... ...of security and compliance as we scale. In this... ...use to keep our payment system safe. This... ...Denver, CO (with remote flexibility) and comes... ...concise manner. Integrity & Compliance...Remote workFraudFull timeWork experience placement
$83.25k - $155.51k
...Job Summary Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive... ...challenges that impact cost-containment and regulatory compliance. Essential Job Duties Business Leadership &...Remote workTemporary workWork experience placementWork at office- ...system. With fully integrated solutions, Valenz... ...and management to payment integrity, plan performance... ...As a Sr. Product Compliance Specialist -... ...compliance lead for regulatory requirements... ...Act (NSA), Fraud, Waste & Abuse (FWA... ...This is a fully remote position, and we’ll...Remote workFraudFull timeImmediate startFlexible hours
- ...Healthcare in Scottsdale, Arizona, is looking for a Lead Analyst to support health plan payment integrity activities. You will drive health plan financial... ...performance through operational initiatives, ensuring compliance with Medicare and Medicaid standards. The ideal...Remote job
$83.25k - $155.51k
Molina Healthcare is seeking a lead-level Business Analyst for Payment Integrity activities in Miami, Florida. This role involves partnering with leadership... ...through operational initiatives, ensuring compliance with regulatory standards. Qualifications include at...Remote job- Molina Healthcare is seeking a Lead Analyst in Austin, Texas. This role involves providing critical support for payment integrity activities to enhance financial performance. You... ...improving claim payment accuracy while ensuring compliance with regulatory requirements. The ideal...Remote job
$83.25k - $155.51k
Molina Healthcare is seeking a Lead Level Analyst to provide support for health plan payment integrity activities. You will partner with leaders to enhance financial performance through evaluation and execution of operational initiatives related to payment integrity. Ideal...Remote job- Molina Healthcare is hiring a Lead Business Analyst in San Antonio, Texas to support health plan payment integrity activities. You will collaborate with operational teams and drive financial performance through operational initiatives. The ideal candidate has at least...Remote job
- A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment integrity... ...candidate will also ensure compliance with healthcare auditing standards... ...improving service delivery. This remote position requires strong experience...Remote jobDaily paid
$83.25k - $155.51k
Molina Healthcare is looking for a lead level Business Analyst to support health plan payment integrity activities in Cincinnati, Ohio. The ideal candidate will analyze... ...52 - $155,508 annually, with the flexibility of remote work options. #J-18808-Ljbffr Molina HealthcareRemote job- ...Cross and Blue Shield of North Carolina is looking for a Payment Integrity Ideation Lead who will drive new audit concepts and reimbursement policies... ...offers a hybrid flex working arrangement, including remote opportunities. #J-18808-Ljbffr Blue Cross and Blue Shield...Remote workFlexible hours
- Molina Healthcare is seeking a lead level analyst to support health plan payment integrity activities in Des Moines, Iowa. The role involves collaboration with... .... Key responsibilities include managing compliance projects, analyzing claims data, and providing strategic...Remote job
- Molina Healthcare is seeking a Lead Business Analyst to enhance health plan financial performance. The role involves managing operational initiatives for payment integrity and provider claims accuracy. The ideal candidate has over 4 years of experience in a managed care...Remote job
- Blue Cross and Blue Shield of North Carolina is seeking a Payment Integrity Ideation Lead to drive the creation of new audit concepts, data models,... ...supports a hybrid work model with flexible on-site and remote options. #J-18808-Ljbffr Blue Cross and Blue Shield of North...Remote workFlexible hours
$87.7k - $157.8k
...implement and manage strategic fraud, waste and abuse activities by maintaining... ...processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workFraudFull timeContract workPart timeWork at officeImmediate startFlexible hours- ...documentation, and billing integrity. Establish workflows,... ...referral process to fraud, waste, and abuse... ...documentation for SIU or compliance. Qualifications Bachelor... ...provider education, payment integrity vendor outputs... ...‑flexible hybrid or remote role with autonomy and...Remote workFraudFlexible hours
- Molina Healthcare in Albany, NY seeks a Lead Analyst for payment integrity activities. This role involves driving financial performance through evaluating operational initiatives and managing compliance with CMS and state regulations. The ideal candidate will have significant...Remote job
- ...candidate to analyze medical claims, identify trends, and ensure compliance with guidelines. The role requires a Bachelor’s degree and... ...experience with PC SAS, SQL, and Microsoft Excel. The position supports remote work options with flexibility to reside in multiple states. The...Remote job
$91.66k - $120.3k
...We're hiring a Program Lead, Payor Connections/... ...Location: This is a remote position, open to candidates... ...connections to ensure compliance and functionality... ...related to data quality or integration, and ensure continuous... ...from recruitment fraud here. At Oscar, being...Remote workFraudFull timeWork experience placementWork at office$92.7k - $139.1k
...work arrangements that include remote and hybrid opportunities and... ...the organization, you’re an integral part of our team and your input... ..., in‑depth analysis of claim payments and its methodology,... ...submission and reimbursement is in compliance with state and federal guidelines...Remote workContract workWork at officeWork from homeFlexible hoursShift work2 days per week1 day per week- ...fully embrace working remotely and we are eager... ...is to build, lead, and scale Bitso’s global crypto payment operations. You will... ...streamlined operations. Integrity & Transparency →... ...meet evolving compliance and security standards... ...spanning fraud prevention, money...Remote workFraud
- A leading fashion retailer in Cerritos, California seeks a Senior Manager of Payments and Fraud to drive strategy in optimizing payment processes and managing fraud. You will oversee... ..., collaborate with teams, and ensure compliance with industry regulations. Ideal...Fraud
- The Lead Technology Operations Analyst-Payments oversees cross‑functional teams to understand complex solutions and integrations, as well as drive releases to improve... ...runbooks) that ensure compliance with the best practices... ...understanding of remote deployment tools, integration...Remote workWork at office
$101.23k - $172.36k
Payments Fraud Analytics Lead Lead the bank's fraud prevention and risk management activities for payment systems to mitigate exposure to fraudulent... ...is an essential function of the job unless otherwise indicated as fully remote. #J-18808-Ljbffr City National BankRemote workFraud- Kerma Games is seeking a Game Integrity Manager to protect game integrity across live casino and digital... .... This critical role involves overseeing fraud detection and compliance, ensuring game fairness and security. You will lead investigations, monitor gameplay, and...FraudWeekend workAfternoon shift
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