• Process Risk & Claims Audit Manager

    Grant Thornton (New York, NY)
    As a Process Risk & Claims Audit Manager, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... and help you achieve more, confidently. Your day-to-day may include: + Leverage claims operations experience and claim audit experience to review and analyze… more
    Grant Thornton (10/10/25)
    - Related Jobs
  • Claims Specialist, Audit

    LogixHealth (Dania, FL)
    Location: On-Site in Dania, FL This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We offer a… more
    LogixHealth (10/10/25)
    - Related Jobs
  • Billing Specialist - Audit / Claims

    AnMed Health (Anderson, SC)
    …to account information. Prepares and files electronically or hard copy claims . Stays current of all Government/State/HIPPA, etc., rules and regulations pertaining ... Care, rules, and regulations governing billing compliance. + Gather and analyze medical records and billing for insurance payer audits. + Responsible for quarterly… more
    AnMed Health (09/17/25)
    - Related Jobs
  • Analyst - Fraud, Waste & Abuse

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …and Payment Integrity monitoring activities + Collaborate with other departments such as Claims , Medical Management, Internal Audit , Recovery and Legal teams ... with regulatory requirements + Maintain process integrity and ensure legitimate claims are processed efficiently + Implement and track corrective action plans… more
    DOCTORS HEALTHCARE PLANS, INC. (10/13/25)
    - Related Jobs
  • Medical Biller - Healthcare Claims

    Guidehouse (San Marcos, CA)
    …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... any and all related job duties as assigned. **_The medical biller will be working a Hybrid schedule of...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… more
    Guidehouse (09/18/25)
    - Related Jobs
  • Claims Manager

    CHS (Clearwater, FL)
    claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing… more
    CHS (08/08/25)
    - Related Jobs
  • Medical Claims Auditor

    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 Hours: 40 ... perform onsite audits (1-4 times per month) + Evaluate claims and provider documentation for compliance and accuracy +...documentation for compliance and accuracy + Collaborate with internal audit teams and leadership to maintain audit more
    Robert Half Accountemps (09/30/25)
    - Related Jobs
  • Sr. Medical Claims Examiners (3+…

    NTT DATA North America (Ontario, CA)
    NTT DATA is currently seeking **Senior Medical Claims Examiners (3+ years of Xcelys required)** to join our US based team. This is a 100% remote role. **Must be ... To serve as a senior-level adjudicator and SME for medical claims within the Xcelys environment. Provide... processed per day / throughput + Accuracy / audit scores + Rework / error rate + Turnaround… more
    NTT DATA North America (09/27/25)
    - Related Jobs
  • Work Comp Claims Services Associate…

    Sedgwick (Sacramento, CA)
    …in audit exceptions. + Reviews and updates notes/diaries in claims management system as instructed. + Coordinates jurisdictional training on state specific ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Services Associate | Hybrid | Sacramento, CA Are you looking for an… more
    Sedgwick (07/25/25)
    - Related Jobs
  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    … and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer ... Duties and Responsibilities:** + In accordance with company guidelines, performs random medical audits, target audits, re-audits, etc and audits for claims more
    CHS (09/13/25)
    - Related Jobs