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Claims Operations Audit Analyst Jobs

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  • 3.4
    Valley Medical Center – Renton, WA
    Est. Salary $55k-$84k
    12 days ago 12d
    340(B) Quality Assurance Auditing Duties: Evaluate qualified and non-qualified claim identification by reviewing patient… Pharmacy Services, the analyst performs a variety of duties including: Monthly quality assurance audits to ensure compliance…
  • 3.3
    DaVita Medical Group – Saint Petersburg, FL
    15 days ago 15d
    We are seeking a Claims Audit Analyst to join our talented team! Overview: The Claims Audit Analyst reports to the Manager… Manager, Health Claims Audit & Recovery and reviews medical claims on risk contracts for payment accuracy and recovery. Essential…
  • 2.9
    Glu Mobile – San Francisco, CA
    Est. Salary $60k-$90k
    15 days ago 15d
    more, follow this link: http://www.glu.com/ The HR Operations Analyst is responsible for leading the effective execution of… system testing. Conduct periodic data audits for Jobvite and Workday system. Misc HR Operations projects such as M&A and restructuring…
  • 3.4
    Lowe's – Mooresville, NC
    18 days ago 18d
    The Sr. Claims and Audit Analyst will collaborate directly with Repair Services Vendor Management Teams, OFR Operations Manager… The Sr. Claims and Audit Analyst is primarily responsible for the development and execution of complex performance and business…
  • 3.3
    Health First – Rockledge, FL
    Est. Salary $34k-$49k
    9 days ago 9d
    The Senior Claims Analyst is primarily accountable for supporting the administration of Health First’s claims management program… on problematic claims. Prepare periodic Board reports regarding pending litigation and high dollar claims. Audit invoices for…
  • 3.0
    Esurance – Tampa, FL
    Est. Salary $45k-$73k
    18 days ago 18d
    the Claims Department and the Claims Process Manager in continually reviewing and analyzing all aspects of claim operations to… or systems logic. Conducts process audits, identifying and escalating trends to the Claims Process Manager and SMG. Facilitates…
  • 3.0
    National Vision – Duluth, GA
    Today 9hr
    opportunities. The Sales Audit Analyst is responsible for the completion of daily audits and reconciliations of sales and… closing of store bank accounts. Uploads from vendors weekly claims for NSF (non-sufficient funds) and create journal entry to book…
  • 4.5
    Memorial Hospital Los Banos – Sacramento, CA
    Est. Salary $43k-$60k
    Today 2hr
    in a fast paced, dynamic environment, the Audit Analyst contributes to Internal Audit’s success through their primary responsibilities… departmental applications. This role challenges the Audit Analyst to further develop and refine their skills and abilities for accessing…
  • 2.4
    DXC Technology – Conway, AR
    Est. Salary $41k-$77k
    15 days ago 15d
    information, visit www.dxc.technology. In this Business Analyst (Claims: Edits/Audits) role you will apply developed subject matter knowledge… experience. Essential: * 4 years' experience in Claims, Edits and Audits supporting MMIS projects. * Healthcare domain experience…
  • 3.4
    MultiPlan Inc. – Arlington, TX
    Est. Salary $52k-$72k
    3 days ago 3d
    experience in healthcare industry; preferably with claims processing, auditing and/or customer service. * Minimum 2 years' experience… smooth and efficient operations. JOB ROLES AND RESPONSIBILITIES: 1.Manage daily quality audit operations and processes within…
  • 2.4
    Acceptance Insurance – Nashville, TN
    Est. Salary $37k-$59k
    3 days ago 3d
    Assurance Analyst are to coordinate, plan and perform claims file audits including Departmental as well as focused audits for financial… to be involved in more than one audit at a time. The QA Analyst is to manage a variety of claims software systems and administer…
  • 2.7
    San Francisco Health Plan – San Francisco, CA
    Est. Salary $77k-$107k
    12 days ago 12d
    ongoing operational stability of the report inventory and ETL objects, ensuring they are properly monitored and audited to provide… enterprise-wide dissemination of critical Provider, Member, Claims and Encounter information throughout the company. ETL development…
  • 3.5
    Blue Cross and Blue Shield of Massachusetts – Hingham, MA
    Est. Salary $41k-$63k
    13 days ago 13d
    is over - it happens here. The analyst in this role is responsible for performing claims analysis for the Medicare Markets… management as well claims testing efforts. In addition, this position serves as a primary support for audit activities and cross-functional…
  • 3.8
    Zelis Healthcare – Bedminster, NJ
    10 days ago 10d
    Editing Operations in claim analysis, medical record review and overall claim workflow while conducting diligence and quality assurance… to facility claims by conducting research, customizing response letters and adhering to Zelis standard operating procedures.…
  • 3.3
    Hu-Friedy Manufacturing Company – Chicago, IL
    25 days ago 25d
    including communication with broker, insurer, and claimants, claims review and management, return to work programs, OSHA reporting… .hu-friedy.com. We are currently seeking a Total Rewards Analyst to be based in our Chicago Headquarters. I. Summary of Position…
  • 3.2
    MemorialCare Health System – Fountain Valley, CA
    3 days ago 3d
    experience should include financial and operational analysis, data manipulation and modeling. Audit and prepare Budget, Financial Statement… not limited to forecasting, pricing, reserving (IBNR unpaid claim cost estimates), trending, valuation, variance and risk management…
  • 3.2
    Walgreens – Deerfield, IL
    Est. Salary $55k-$81k
    13 days ago 13d
    Third party audit requests are in compliance with government regulations and contract terms. Addresses issues / claims and corrects… Senior Tax Analyst, State Income and Sales & Use Tax Audits (Job Number: 024043) US-IL-Deerfield Deerfield Corp North…
  • 2.6
    CoreSource – Lancaster, PA
    Est. Salary $55k-$106k
    10 days ago 10d
    least one of the following; call center, claims, eligibility, and billing operations. Experience in communicating with clients… by working in concert with direct reports, Business Analysts, IT Operations, Finance, CoreSource Executive Leadership members and…
  • 3.7
    UDR – Highlands Ranch, CO
    Est. Salary $30k-$46k
    16 days ago 16d
    Title Claims Analyst City Highlands Ranch State CO Location Denver Office Description UDR, Inc. is seeking… seeking a Claims Analyst to join our team at our Corporate Office in Highlands Ranch, CO. GENERAL SUMMARY OF DUTIES: Handles subrogation…
  • 3.1
    KentuckyOne Health – Louisville, KY
    10 days ago 10d
    The Quality Data Analyst will utilize tools from occurrence reports, safety surveys, claims data, clinical audit tools and other… / Manager, the Quality Data Analyst assists in data collection and preparation for all operational aspects of the Quality Division…
  • 3.3
    L.A. Care – Los Angeles, CA
    Est. Salary $77k-$108k
    11 days ago 11d
    participates in internal and external audits and provides support to the Claims Operation process and oversight on metrics as well… Key liaison between Claims Compliance and technical staff. The Claims Compliance Data Validation Analyst also ensures that L.A…
  • Davies Group – United States
    Est. Salary $34k-$51k
    17 days ago 17d
    Vacancy: Junior Claims & Operations Analyst Division: Property Location: Banding: 2 Contract… will enhance the operational oversight available to the DMS management team To audit a mix of call and claim experiences for…
  • 3.3
    Chubb Corp – Philadelphia, PA
    Est. Salary $41k-$64k
    24 days ago 24d
    strength, underwriting excellence, superior claims handling expertise and local operations globally. Provide support to assigned… locating policies, underwriting material, layoffs, fac certs, claim file materials and proofs of loss documents using electronic…
  • 4.4
    GAINSCO, INC. – Dallas, TX
    Est. Salary $45k-$72k
    16 days ago 16d
    monthly open and post-payment audits of claims randomly selected from our claims database claims paid. Identify accuracy results… Auto Insurance has an immediate opening for an Claims Quality Assurance Analyst. We are looking for driven individuals who want…
  • 2.8
    Guardian Pharmacy – Phoenix, AZ
    4 days ago 4d
    related to NPI, High Dollar Claims and other audit related metrics that would expose risk for potential audits and report to management… to ensure all deadlines for audits are met in an efficient manner. Investigate and analyze claims data; applying knowledge of…
  • 4.4
    Johnsonville Sausage – Sheboygan Falls, WI
    Est. Salary $52k-$83k
    17 days ago 17d
    process and provide claim and other accounting support on an as needed basis, including workers compensation claim analysis Take… Posting Senior Risk Analyst Finance Position Overview: The Senior Risk Analyst will be responsible for developing…
  • 3.2
    MHN – Raleigh, NC
    14 days ago 14d
    The Senior Audit Analyst is responsible for the quality review of functionally specific processes within operations services (claims… (claims, customer contact and membership) to ensure quality service goals and standards are met and/or identify areas where improvement…
  • 3.6
    First Acceptance Corporation – Nashville, TN
    Est. Salary $40k-$64k
    3 days ago 3d
    Assurance Analyst are to coordinate, plan and perform claims file audits including Departmental as well as focused audits for financial… to be involved in more than one audit at a time. The QA Analyst is to manage a variety of claims software systems and administer…
  • 2.1
    Highmark Health – Pittsburgh, PA
    4 days ago 4d
    appropriate processing of adjustments and/or duplicate claims through an audit sampling review process. Develop management reports… quality and operational staff Identify any potential fraudulent activity relating to adjustment and/or duplicate claim processing…
  • 2.8
    ACE Group – Philadelphia, PA
    Est. Salary $36k-$55k
    24 days ago 24d
    strength, underwriting excellence, superior claims handling expertise and local operations globally. Provide support to assigned… locating policies, underwriting material, layoffs, fac certs, claim file materials and proofs of loss documents using electronic…
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