Remote QA Analyst - Healthcare Claims & Data Audit
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tango is seeking a Quality Assurance Analyst to join our growing healthcare team in Phoenix. The role focuses on validating claims data, analyzing billing accuracy, and developing audit determinations with objective documentation. You will escalate issues, support audits, and ensure compliance with rebuttal timelines while maintaining production quality metrics. Candidates should have deep knowledge of claims processing, enrollment, and regulatory requirements, with strong communication and #J-18808-Ljbffr Remote Jobs
$84.34k
Remote Health Insurance QA Analyst Introduction Join a forward-thinking health... ...efficient claims processing, streamlining... ...align with evolving healthcare regulations. This is... ...Key Responsibilities Audit & Validate Health Insurance... ...patterns and use data insights to drive...Remote jobDataClaimsWork from homeHome officeFlexible hours- Relq Technologies Llc. is seeking an experienced Healthcare QA Analyst focused on Membership and Claims processing, with hands-on testing of EDI 834... ...applications, enrollment workflows, and payer data validation in a remote US setting. Required: 5+ years in healthcare...Remote jobDataClaims
- ...seeking a Clinical Quality Assurance Analyst to perform chart reviews, audits, and data validation to uphold accuracy and... ...enterprise quality initiatives in a remote-capable environment. The role requires 5+ years in clinical healthcare or auditing, plus 4+ years in...Remote jobData
- .... Evaluate pharmacy claim-support activity for adherence... ...and maintain complete audit records. Track and... ...when reviewing healthcare, insurance, and pharmacy... ...be onsite, hybrid, or remote depending on the assigned... ...interactions, documentation, and data analysis. Physical...Remote workDataClaimsFull timeWork at officeWeekend work
- ...serving several Medicare Healthcare companies. At Convey... ...Job Description The QA Analyst NC will provide the highest... ...met through process auditing.Under the guidance and... ...2) External Client RX Claims System, Non Call QA... ...detail.• Computer and data entry proficiency.• In...DataClaimsWork at officeLocal area
- ...Test Scenarios Defect Reports Position Title: Healthcare QA Analyst (Membership & Claims) Location: Remote (USA) Duration: 6+Months Contract Employment Type... ...payer systems, HIPAA regulations, and healthcare data validation. Required Skills 5+ years of QA experience...Remote workDataClaimsContract work
- A healthcare organization is seeking a remote Billing Analyst to assist with pre-bill audits and manage patient data entry. The ideal candidate will have strong interpersonal communication skills, a commitment to quality and integrity, and be adept in a collaborative setting...Remote jobDataClaims
- Cotiviti Healthcare seeks a Payment Accuracy Specialist to join our data mining team in the United States. You will audit client data and generate high-quality recoverable claims, applying CMS/NAIC guidelines and our Recovery Management System to identify over- and under...Remote jobDataClaims
- Lumicera is seeking an Analyst, Contract Operations to join our team in a data-driven role focused on PBM contracting, rebates, and healthcare analytics. You will analyze claims data, support contract design,... ...reconciliation, RFP responses, and audits, translating complex data...Remote jobDataClaimsContract work
$67k - $76k
...advancing rural and community healthcare, Xtensys is executing... ...Work Arrangement : Remote Compensation Range:... ...for reviewing and auditing documentation and coding... ...as is familiarity with data entry in a physician billing... ...billing platforms and claim workflows—how coding...Remote workDataClaimsFull time- ...seeking a Quality Auditor to conduct audits in healthcare operations, ensuring compliance... ...improving processes. The role is remote/telecommuter, with emphasis on data analysis and root-cause problem... ...candidates will have at least 3 years in claims or enrollment work with a quality...Remote jobDataClaims
- ...performance within the Alliance network. The role includes reviewing claims data, clinical documentation, provider contracts, and policies,... ...identify irregularities and non-compliance. The position is remote with travel on an as-needed basis for on-site reviews,...Remote jobDataClaims
$85k - $92k
...real impact in healthcare quality? EXL Health... ...Quality Analyst – QC Coder to join our remote team! If you’re... ...outpatient coding audits—ensuring every audit... ...validate coded data against medical... ...Manage assigned QA inventory and meet... ...Assistant, the Medicare Claims Processing...Remote workDataClaimsFull timeLocal area- Supporting the accuracy of healthcare claims processes, the full-time remote Health Admin Services Senior Analyst will analyze complex claims issues, review coding and auditing practices, and collaborate with... ...with healthcare claims data or claims-processing systems...Remote workDataClaimsFull time
- Centene Corporation seeks a Data Analyst to audit and analyze provider data against claims processing systems, supporting cost-saving initiatives and regulatory compliance. You will document audit results, investigate discrepancies, and communicate findings to management...Remote jobDataClaims
$70k - $110k
...The IRF Quality Analyst performs random, targeted... ...to confirm that audit determinations are... ...Location 100% Remote U.S.-based A... ...Management, healthcare administration, nursing... ...inpatient facility claim review, medical... ...documentation, coded data, IRF-PAI elements,...Remote workDataClaimsFull time$145k - $170k
...Healthcare organizations are under more compliance pressure... ...in the right place. Audit Manager is our solution... ...pipeline and forecast data reflect reality.... ...(such as CPT, ICD-10, claims, and denials). This doesn... ...unlimited PTO. A remote-first role, with the option...Remote workDataClaimsFull timeSecond jobImmediate start$50k
...Claims Processors Location: Denver, CO 80210 Duration... ...thereafter- but can be Remote if you perform well... ...and processes claim audits to maximize accuracy and... ...guidelines. Monitor Smart Data claims activity and... ...a doctor’s office, healthcare clinic or other healthcare...Remote workDataClaimsContract workWork at officeShift work$85.7k - $129.31k
...consulting on clinical charge Audits for Intermountain... ...as well for fully remote position. Essential... ...denials with members of the healthcare team. · Serve as a subject... ...of the healthcare claim denial process. · Demonstrates... ...and follow strict data protection rules. Your...Remote workDataClaimsHourly payFull timeWork at officeFlexible hours$31.2 - $40.56 per hour
...the region's largest not-for-profit healthcare organization, with 12 hospitals, over... ...will be responsible for complex audits of clinically coded data to assess coding quality for accuracy... ...efficiency in outpatient or inpatient claims processing and data collection to optimize...Remote jobDataClaimsLocal area$30.5k - $45.76k
...solutions that solve some of healthcare's most complex... ...structured workflows, data entry, and documentation... ...working in a fast-paced, remote environment. Your role... ...in accordance with audit, contract, and policy requirements... ...work, retail pharmacy, claims, or similar...Remote workDataClaimsFull timeContract workWork at officeWork from homeFlexible hoursShift work$90k - $105k
...Machinify is a leading healthcare intelligence company... ...Facility (SNF) medical claims audit reviews. As a MR Nurse... ...Payers. You will work remotely in a fast-paced and dynamic... .... Assist with QA functions and training... ..., copying and pasting data from one document to...Remote workDataClaimsFull timeFor contractorsWork at office$55k - $65k
...transform underwriting, claims, and fraud and risk -... ...insurance.As part of our US Healthcare Payment Integrity and... ...logic, assist with audits, and identify opportunities... ...: Ability to review data and identify trends or... ...to highlight:Flexible remote and hybrid working optionsCompetitive...Remote workDataClaimsPermanent employmentFull timeApprenticeshipInternshipFlexible hoursShift work- ...Finance Location Remote (US Based – CST or EST... ...Exempt Industry Healthcare Technology / Insurance... ...delivery model — such as claims administration, provider... ...digital mailroom management, data capture, member... ..., cash flow oversight, audit support, financial compliance...Remote workDataClaimsFull time
- ...The Marwood Group is a healthcare advisory services firm headquartered... ...in its New York office or remotely. Principal duties and... ...Perform remote billing and coding audits to ensure client coding... ...with both UB-04 and CMS 1500 claims data, as well as understanding of...Remote workDataClaimsWork at officeLocal area
- ...in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access... ...system, ensuring the highest level of data integrity and audit readiness. Collaborate... ...members, contributing to their growth and development. #J-18808-Ljbffr RemoteRemote workDataClaims
- ...for a detail-oriented Claims Auditor to join our team... ...processing within a dynamic healthcare management environment.... ...you! Responsibilities: Audit medical claims for... ...Review and analyze claims data to identify billing... ...healthcare industry. This is a remote position. #J-18808-...Remote workDataClaimsWork at office
- ...this by building a new mental healthcare system everyone can access. We... ...The admin work - credentialing, claims, payment reconciliation - is a... ...with Finance, People, Legal, Data, Product, and Engineering to... ...impact on Headway's operations and audit readiness. You Will:...Remote workDataClaims
- ...revenue flow by ensuring all healthcare providers meet rigorous... ..., maintaining audit-ready records, and liaising... ...reviewer application data, performs online searches... ...? Collaborative remote culture Professional... ...over 200,000 insurance claims annually for leading...Remote workDataClaimsTemporary workWork at officeLocal areaWork from home
- ...Machinify is a leading healthcare intelligence... ...The Medical Review Audit Supervisor is a working... ...who leads a remote team of clinical auditors... ...limited volume of SNF claim reviews; serve as... ...with the QA team to translate audit... ...production and quality data to identify trends,...Remote workDataClaimsFull timeFor subcontractorWork at office
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