- Prime Therapeutics (Richmond, VA)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims ... analysis of large datasets and audit findings to detect high-risk pharmacy claims , identify billing irregularities, and uncover patters of non-compliance or systemic… 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
- Sedgwick (Buffalo, NY)
- …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
- Elevance Health (San Juan, PR)
- …technology and business operations services for health plans. **Performance Quality Auditor I** **Location:** This role requires associates to be in-office [2] ... balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. When report to the… more
- BayCare Health System (Tampa, FL)
- …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
- FlexStaff (Chappaqua, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in ... Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and… more
- Sharp HealthCare (San Diego, CA)
- …factors, other requirements for the position, and employer business practices. *This is a remote position* **What You Will Do** The Compliance Coding Auditor is ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and chart… 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 . The work authorization is not specified and the ... 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
- MD Anderson Cancer Center (Houston, TX)
- As a *Nurse Defense Auditor * in our *Hospital Billing & Collections* department, your expertise ensures accurate reimbursement and supports patient access to ... management, and utilization review to request reconsideration and/or appeal of claims requiring clinical intervention, ensuring comprehensive data is provided to… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …member of the Audit and Risk Management (ARM) team, the Senior Internal Auditor will lead and execute a variety of financial, operational, and risk-based audits ... reporting and risk-based audits of these areas (eg Enrollment, Premiums, Claims Operations, Provider Enrollment and Pricing, Accounting, and Information Technology… more
- Healthfirst (NY)
- **This position is 100% Remote .** **Scope of Responsibilities:** + **Conduct moderately complex to complex quality audits of provider claims , pre-payments and ... to ensure the quality of the network.** + **Review and investigate claims and encounters for medical, facility, pharmacy, dental and vision services including… 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
- 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
- RTX Corporation (Hartford, CT)
- **Date Posted:** 2025-11-20 **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
- Catholic Health Initiatives (Little Rock, AR)
- …have oversight for Arkansas, Tennessee/Georgia, Kentucky and Ohio markets. Work-mode is flexible/ remote ; preferably reside either in the EST or in CST zones, and ... all things quality and risk for the value hub. + Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and… more
- Warner Music Group (New York, NY)
- …the contractually-defined scope) of the audit concerned; + Review and analyze the audit claims submitted by the auditor in question, as well as the relevant ... including, without limitation, tracking audit notifications, reviewing and analyzing the claims contained in the audit reports we receive, making recommendations to… 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
- Ross Stores, Inc. (Dublin, CA)
- …and approve auditor responses on Estoppels, Waivers, CERs, and cotenancy claims \. * Act as liaison between company \(Real Estate Management, Risk Management, ... perform duties effectively using a combination of in\-office and remote work\. **SUPERVISORY RESPONSIBILITIES:** Lease Auditors **DISCLAIMER** This job description… more
- DoorDash (San Francisco, CA)
- …automation of recurring workflows + Collaborate with cross-functional teams-including Claims , Finance, and Legal-to incorporate operational insights into actuarial ... Notice to Applicants for Jobs Located in NYC or Remote Jobs Associated With Office in NYC Only We...The Covey tool has been reviewed by an independent auditor . Results of the audit may be viewed here:… more
- McKinstry (Spokane, WA)
- …+ Drive continuous improvement projects to reduce defects, rework, and warranty claims , using production quality data to identify and prioritize activities and ... Manufacturing preferred. + Lean Belt Certification preferred. + SO 9001:2015 Lead Auditor certification. + Working knowledge and understanding of the ISO 9001:2015… more
Related Job Searches:
Auditor,
Claims,
Claims Auditor,
Pharmacy Claims Auditor Remote,
Remote,
Remote Auditor,
Remote Claims