- Marshfield Clinic (Marshfield, WI)
- …teamwork come together to support the most exciting missions in the world!** **Job Title:** Claims Auditor ( Remote - WI or MN) **Cost Center:** 682891379 ... day shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy,… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report....work in a "hybrid" style, with a mix of remote , in-person and in-office interactions dependent on the needs… more
- Amergis (Los Angeles, CA)
- …+ Level I Trauma & Teaching at Large Hospital REQUIRED + Prefer someone from a big time University Medical Center + Recent experience auditing and educating coders ... Salary: $50 / Hour Position Overview: + Primary Responsibility: OP Claim Edits - Must have extensive experience in this area + Audit HB SDS / Observation cases (may see some ED cases) + Will see a wide range of HB surgical specialties + Potentially lots of… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire ... 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities...perform onsite audits (1-4 times per month) + Evaluate claims and provider documentation for compliance and accuracy +… more
- Humana (Boise, ID)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Sedgwick (Annapolis, MD)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- CareFirst (Baltimore, MD)
- …for systematic investigations of a specific area of operations (ie, claims , customer service, enrollment) within the organization. Incumbent conducts a variety ... to negotiate effective solutions to audit issues. + Knowledge of all claims , service and enrollment processing systems. + Excellent communication skills (verbal and… more
- BayCare Health System (Raleigh, NC)
- …7:00 AM to 3:30 PM + **Days:** Monday - Friday The Inpatient Coding Auditor is a full-time remote position. _Sign on bonuses available!_ Responsibilities + ... the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the state of Florida, Georgia,...The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related… more
- State of Colorado (Denver, CO)
- Compliance Auditor III Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5091285) Apply Compliance Auditor III Salary $4,906.00 - $7,849.00 ... Two (2) days in office and Three (3) days remote Please note: These working arrangements are subject to...you have working in the CBMS system (data entry, claims resolution, etc.)? + < 1 year of experience… more
- UPMC (Pittsburgh, PA)
- …full time position working Monday through Friday daylight hours and will be fully remote .. The Clinical Auditor /Analyst is an integral part of the Risk ... UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote . This person should have an extensive background in ... is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will ... Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be… more
- WellSense (Boston, MA)
- Claims Quality Assurance Inspector WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through ... our members, no matter their circumstances. **Job Summary:** The Claims Quality Inspector is responsible for the thorough and...all review functions. Our Investment in You: . Full-time remote work . Competitive salaries . Excellent benefits **Key… more
- DoorDash (Tempe, AZ)
- …company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward ... DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's...Notice to Applicants for Jobs Located in NYC or Remote Jobs Associated With Office in NYC Only We… more
- State of Colorado (Denver, CO)
- Nutrition Claims and Finance Consultant Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5083346) Apply Nutrition Claims and Finance ... residents. Primary Physical Work Address Downtown/Denver Metro/Eligible for a hybrid (office/ remote ) work environment. FLSA Status Exempt; position is not eligible… more
- RTX Corporation (Hartford, CT)
- **Date Posted:** 2025-10-03 **Country:** United States of America **Location:** PW208: Connecticut Remote Remote Location , Remote City, CT, 06035 USA ... you ready to go beyond?** We have an exciting ** remote ** work opportunity for a **Manager, Global Trade** !...Will Do:** + Support valuation reconciliation. + Support drawback claims . + Support post summary corrections. + Support resolution… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, ... correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, abstracting,… more
- Medical Mutual of Ohio (OH)
- …by members, and members' health outcomes.** **Note: This is a fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more
- DoorDash (San Francisco, CA)
- …business by managing corporate insurance programs and mitigating risk across Actuarial, Claims Operations, and Risk Management & Mitigation. We operate at the ... cross-functionally to drive compliance and resilience. This role is remote -friendly within the US, with a preference for candidates...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Control Testing in various process areas such as entity level controls, claims , enrollment operations, IT general computer, and application related controls, etc.* ... IT Audit project assistance* Attend operational audit planning meetings* Support Auditor in Charge with testing of operational audit(s)* Participate in entrance… more