Remote Claims Quality Analyst — Medicare/Medicaid Adjudication
Navitus Health Solutions, LLC
- Remote job
Navitus Health Solutions, LLC is hiring a Claims Quality Analyst to validate Med D, Medicaid, and Exchange claims per regulations. Responsibilities include auditing claim data, assisting with monitoring and testing, and managing process changes. Candidates should have a degree in a related field and 1-3 years of relevant experience. Benefits include competitive health insurance, 20 days paid time off, and a 401K match. This role is remote except for certain states. #J-18808-Ljbffr Navitus Health Solutions, LLC
$24 per hour
...Claims Quality Assurance Analyst The Claims Quality Assurance Analyst is responsible... ...supporting commercial, Medicaid, and Medicare lines of business,... ...through it. Including how to adjudicate an audit appeal... ...development opportunities Remote Opportunities We are...Remote workHourly payTemporary workLocal areaFlexible hours- ...scenarios, executing tests, and providing UAT support. Key skills include a strong knowledge of Medicaid, CHIP, SNAP, and TANF programs. The position is contract-based and remote, geared towards candidates with mid-senior level expertise in IT consulting and services. #J-...Remote jobContract work
- ...Description Job Description Medicaid Business / QA Analyst ~7–12+ Month Contract | Remote | No ThirdParty Firms |... ...and processes while performing quality assurance testing within a large... ...program knowledge—eligibility, claims, encounters, provider enrollment...Remote workContract work
$70k
...French Bilingual, Claims Quality Assurance Analyst Trupanion is a leading provider of medical insurance... ...consistency of pet medical claims adjudication across Claims teams and geographies.... ...professionals are everywhere. This is a remote position open to candidates anywhere...Remote workFull timeCasual workWork at officeImmediate startFlexible hours- Claims Quality Analyst | Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: Claims Quality Analyst... ...settings / healthcare claims or in a claims processing/adjudication environment Hands‑on experience with EZCap (strongly preferred...Remote jobFull time
$23 per hour
W e are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy... ...-Time position. This is a remote hybrid opportunity, after... ...will adjudicate pharmacy claims, review claim responses for... ...knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP...Remote workFull timeTemporary workWork experience placementRelocation packageFlexible hoursShift work- ...MetroPlusHealth provides the highest quality healthcare services to... ...to, New York State Medicaid Managed Care, Medicare, Child Health Plus,... ...Position Overview The Claims Quality Analyst is responsible for reviewing... ...accuracy of the claims adjudication processes and assure...Contract workShift work
- ...Job Title IT - Clemson University - Quality Assurance Analyst - Advanced Quality Assurance Analyst (QA Tester) Location Remote Employment Type Contract (C2C / W2)... ...Project Scope This role supports the Medicaid system for the state of South Carolina by...Remote workContract work
- ...Description Must have Medicaid Rebate experience with... ...working hours. The analyst will receive training during... ...Location: A) Fully Remote (If person is local... ...healthcare experience; Medicaid Claim processing function;... .... Conduct initial quality check on summary data on...Remote workWeekly payContract workWork experience placementWork at officeLocal areaMonday to FridayFlexible hoursShift work
- ...market, is hiring a Claims QA Analyst in Miami and/or Gainesville... ...in office and 3 days remote. Scope of position... ...actions to ensure quality standards are in... ...of manually and auto-adjudicated claims with an emphasis... ...to Virginia Medicaid standards. Bachelor's...Remote workFull timeContract workWork at officeFlexible hours
- ...satisfaction, service, cost, and quality in the healthcare industry... ...Quality Assurance Analyst II - Medicaid FFS serves as a subject matter... ...special projects. Analyze claims adjudication results to identify... ...company location (or from a remote location with management approval...Remote workFull timeWork at officeLocal areaMonday to FridayNight shiftWeekend work
$85.06k - $104.37k
...Product Manager, Claim Adjudication, Medicaid/Medicare Location US- ID 2026-5739 Category... ...Position Type Full-Time Remote Yes Company Navitus... ...Project Management and/or Business Analyst experience a plus Data analysis experience...Remote workFull timeFlexible hours$24.5 - $26 per hour
...Description Come join our amazing team and work remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible... ...the investor/insurer timeframes. Complete quality checks using a scorecard and/or checklist to identify...Remote workWork from home- A leading medical review company based in Washington is looking for a Quality Analyst to oversee the medical file review process. The successful candidate will ensure client inquiries are addressed, verify report accuracy, and maintain high-quality standards. The position...Remote job
- Job Summary The Quality Analyst is responsible for managing the various aspects of the medical file... ...and a media stipend are provided for remote workspace. About Dane Street A fast-paced... .... We process over 200,000 insurance claims annually for leading national and regional...Remote workTemporary workWork from home
$69.15k - $110.64k
A leading mutual insurance provider is seeking a Property Claims Analyst. This remote role focuses on the administration of the Quality Assurance Program and oversight of the appraisal process in property claims. Candidates should have a bachelor's degree preferred and...Remote job- Encova Insurance is looking for a Property Claims Analyst to ensure the quality and consistency of the property claims organization. This remote-friendly role involves administering the Property Claims Quality Assurance Program and overseeing appraisal processes while collaborating...Remote jobFlexible hours
$80.06k - $106.06k
Inland-Empire-Health-Plan- is looking for a Product Configuration Quality Analyst in Rancho Cucamonga, CA. This hybrid role involves ensuring the integrity of claims system configurations, auditing for accuracy, and working closely with various teams for effective claims...Remote job- A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor's degree in healthcare and valid RN license in Florida. Key responsibilities...Remote job
- ImagenetLLC is seeking a Claims Quality Analyst to ensure the accuracy and compliance of claims processing. This remote role requires 3-5 years of experience in healthcare claims, preferably hands-on experience with EZCap. The analyst will conduct audits, analyze disputes...Remote job
- QVC, Inc. is looking for a QA Performance Claims Specialist to work remotely from Pennsylvania. This role involves evaluating product performance claims... ...The ideal candidate will have 5+ years of experience in quality environments and a solid understanding of performance...Remote job
$35 - $41 per hour
...divh2Sr. Medical Coding Quality Analyst/h2pOur client is seeking a... ...hour, and is on a hybrid remote work schedule and fully remote... ...and payer guidelines (Medicare/Medicaid/Commercial)/liliSupport MIPS... ...strong Proficient in EHRs, claims adjudication platforms, and Microsoft Office...Remote jobHourly payFull timeContract workLive inWork at officeRelocationShift work- Imagenetllc in Tampa is looking for a Claims Quality Analyst to ensure accuracy and compliance in claims processing. The ideal candidate will have... ...disputes, and supporting training initiatives. This remote position offers comprehensive benefits including medical, dental...Remote job
$68.04k - $118.8k
...Summary of Job Support the Quality Management department in the development and maintenance of a monitoring and... ...and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Provide analysis of HEDIS-QARR projects, pharmacy adherence...Remote workWork experience placement- ...government agency in Phoenix, Arizona is looking for a Business Quality Assurance Analyst. The role involves coordinating technical support and... ...quality assurance testing. The position offers flexibility for remote work within Arizona and comprehensive benefits including...Remote job
- Senior Technical Recruiter at Talent Groups Location: Remote Mandatory Skills: Medicaid, CHIP, SNAP, TANF Job Summary Strong knowledge of child support application testing. Understand and identify risk, issues, for the testing scope Participate as needed in specific...Remote workContract work
- ...leading health insurance provider in Seattle is seeking a Claims Processor to oversee claims adjudication for various types. Responsibilities include... ...Professional, and Dental claims, while adhering to privacy and quality standards. The ideal candidate should have a High...Remote jobFlexible hours
$120k - $140k
BerryDunn is seeking a Senior Consultant with expertise in Medicaid program integrity and claims audits. The role involves assisting clients in detecting... ...while ensuring compliance with federal regulations. Remote, hybrid, or office work is available, primarily assisting...Remote workWork at office$47k - $67.2k
...a full-time Pharmacy Post-Payment Claims Analyst to join its remote team across the United States. Offering... ...and a strong understanding of Medicaid pharmacy payment systems. This position... .... You’ll work with pharmacy data, adjudication systems, and client policies to...Remote jobPermanent employmentFull timeContract workFlexible hours- Primerica is seeking a Life Insurance Examiner to adjudicate individual life claims. This role requires a minimum of 4 years in adjudicating Life, Health... ...and organizational skills. The position offers a remote working arrangement across the United States. Benefits include...Remote work
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