Remote VP, Pharmacy Claims & Payment Integrity
Remote Jobs
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Cotiviti is seeking a Senior Sales Executive for remote work to drive sales of its Pharmacy Claim Editing and Payment Accuracy solutions in the United States. Candidates should have a strong background in healthcare sales, excellent relationship management skills, and proven success in acquiring new clients. This role requires a Bachelor's degree and extensive experience, including at least 12-15 years in enterprise healthcare hunter sales, preferably selling pharmacy-related solutions. #J-18808-Ljbffr Remote Jobs
- Independence Blue Cross is seeking an Auditor, Payment Integrity to conduct pharmacy claim audits ensuring accurate provider payments while detecting fraud and improving audit processes. This fully remote role requires a Certified Pharmacy Technician with at least four...Remote jobClaimsWork at office
$192k - $275k
...Vice President of Payment Integrity AI Solutions Be part of a team that unleashes... ...efficiency, improved claim review quality, and stronger client value. The VP will be responsible for converting... ...should expect in this role Fully Remote Opportunity with the option to...Remote workClaimsFull timeFlexible hours$69.4k - $99.2k
...Senior Data Mining & Payment Integrity Analyst Be part of a team that unleashes the power of leading-edge technologies... ...that identify improper payments and improve claims accuracy across dental, medical, and pharmacy billing. Using your expertise in healthcare reimbursement...Remote workClaimsFull timeContract workFlexible hours$80k - $90k
6 Degrees Health is hiring a Payment Integrity Appeals RN to join their team. This remote position involves reviewing provider appeals related to claim determinations and ensuring compliance with regulations. The ideal candidate will have experience in claims review and...Remote jobClaims$83.25k - $155.51k
Molina Healthcare is seeking a lead-level Business Analyst for Payment Integrity activities in Miami, Florida. This role involves partnering... ...care organization, strong analytical skills, and expertise in claims coding. The position offers a competitive salary range...Remote jobClaims- ...Senior Analyst to join the Edits team. This remote role involves managing the edit development lifecycle, ensuring payment accuracy, and driving process improvements... ...over 5 years of experience in payment integrity or claims analytics, and hold an active coding certification...Remote jobClaims
- A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...Remote jobClaims
$28.27 - $50.48 per hour
...healthcare organization in San Antonio seeks a Payment Integrity Coding Consultant to ensure medical... ...role offers the flexibility to work remotely from anywhere in the U.S. Candidates... ...providing coding expertise, and tracking claims. Competitive hourly pay ranges from $28...Remote jobClaimsHourly pay- A leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role. Candidates must be based in EST or CST and comfortable with EST... ...include analyzing medical records, handling claims, and utilizing systems like Facets and NASCO. Ideal applicants...Remote jobClaimsContract work
- ...Arizona, is looking for a Lead Analyst to support health plan payment integrity activities. You will drive health plan financial performance... ...4 years of business analyst experience, strong knowledge of claims coding and regulations, and excellent analytical skills. This...Remote jobClaims
$69.38k - $92.28k
...Health Care is seeking a skilled data analyst to support payment integrity and analyze healthcare claims data. This position is crucial for uncovering cost... ...in SQL and modern data tools. The role allows for remote work, but applicants must reside in New York or Vermont...Remote jobClaims$83.25k - $155.51k
Molina Healthcare seeks a Lead Analyst for health plan payment integrity activities in Atlanta, GA. The role includes managing operational projects... ...4 years of experience in managed care, strong knowledge of claims coding, and the ability to lead projects independently. A...Remote jobClaims- A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment... ...maintain a focus on improving service delivery. This remote position requires strong experience in claims processing and excellent communication skills....Remote jobClaimsDaily paid
- ...in Austin, Texas. This role involves providing critical support for payment integrity activities to enhance financial performance. You will partner with various teams and lead efforts in improving claim payment accuracy while ensuring compliance with regulatory...Remote jobClaims
$83.25k - $155.51k
...Business Analyst to support health plan payment integrity activities in Cincinnati, Ohio. The... ...understanding of managed care regulations, claims processing, and strong communication... ...,508 annually, with the flexibility of remote work options. #J-18808-Ljbffr Molina HealthcareRemote jobClaims- ...Analyst in Phoenix, Arizona, to provide oversight on health plan payment integrity activities, partnering with members and stakeholders to... ...The role involves managing compliance initiatives, analyzing claims data, and making impactful recommendations to drive improvements...Remote jobClaims
$83.25k - $155.51k
Molina Healthcare is seeking a Lead Analyst for health plan payment integrity in Columbus, Ohio. The role involves managing operational initiatives and analyzing claims data to improve financial performance and compliance. Candidates should have at least 4 years of business...Remote jobClaims- ...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 organization, is proficient in data...Remote jobClaims
$24.2 - $36.3 per hour
...business of care by preventing inaccurate payments and reducing overall waste in the... ...Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and... ...errors to prevent and recover improper claim payments. This role performs hands-on casework...Remote workClaimsFull timeContract workVisa sponsorship- PacificSource is seeking a Manager of Payment Integrity to lead the strategic design and execution of programs for enhancing payment accuracy. This role involves overseeing claims editing, audits, and vendor management while ensuring compliance with healthcare regulations...Remote jobClaims
- Valenz is hiring a Sr. Compliance Specialist - Payment Integrity to provide compliance oversight for regulatory requirements impacting claims, billing, reimbursement, and payment... ...risk management. You will work in a fully remote environment with a focus on improving healthcare...Remote jobClaims
$83.25k - $155.51k
Molina Healthcare is seeking a Lead Analyst to support health plan payment integrity activities. The candidate will manage operational projects to ensure compliance with regulatory requirements and improve claim payment accuracy. The ideal candidate will have extensive...Remote jobClaims- Signature Performance is seeking a Payment Integrity Analyst to work remotely in the United States. This role focuses on preventing overpayments and ensuring compliance within healthcare claims, involving responsibilities such as leading audits, developing claims editing...Remote jobClaims
- ...health insurance company is seeking a Senior Specialist, Coding Auditor to join their Payment Integrity team. This remote position involves supporting issue resolution, ensuring claims repayment quality, and assisting in root cause analysis. Candidates should have 1+...Remote jobClaims
- ...Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be based in EST or CST and must... ...by healthcare providers warrants a change in claim payment. This is a non-phone, research-heavy role perfect...Remote workClaimsContract work
- ...Job Summary We are seeking an experienced Payment Integrity Specialist to support healthcare claims accuracy, payment validation, and operational improvement initiatives across complex healthcare environments. This role is responsible for managing and coordinating...Remote workClaims
- ...Payment Integrity Product Development Specialist (Skilled Nursing Facility Or Snf Sme) At MedReview, our mission is to bring accuracy, accountability... ...product adjustments as needed. Define and validate claim selection logic, risk indicators and scoring models....Remote workClaims
- ...Job Title: Payment Integrity Project Specialist Job ID: 26-02533 Location: Grand Rapids, MI (100% Hybrid (Onsite Cadence: Tuesday,... ...months on W2 contract TECHNICAL SKILLS Must Have Claims/Healthcare Influencing role Project management of large...Remote workClaimsContract work
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) CGI is seeking a results-oriented Senior Analyst to join our growing Edits team. In this... ...Edit Development & Implementation Identify Opportunities: Use claim data analysis to pinpoint high-impact edit opportunities....Remote workClaims$95.1k - $135.8k
...Payment Integration Product Solution Architect Be part of a team that unleashes the power of leading... ...experience in healthcare, preferably a claim payment or audit recovery environment... ...expect in this role: Fully remote opportunity with the option to work anywhere...Remote workClaimsFull timeFlexible hours
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