Job Type
Date Posted
Salary Range
Distance

Claims Operations Audit Analyst Jobs

551 Jobs

  • 3.7
    Zelis Healthcare – Bedminster, NJ
    $53k-$79k(Glassdoor est.)
    6 days ago 6d
    eligible for audit, clarification of claims submission via CSA request, and determining if a claim is ready for Nurse Distribution.… Monitor aging of in-network claims in the EDI report and determine if audit should continue or have claims returned to client.…
  • 3.7
    Zelis Healthcare – Atlanta, GA
    13 days ago 13d
    management, IT operations, and application development) · Performing periodic testing of internal controls, developing audit workpapers… external IT Services audits including Financial Audits (SSAE-16 SOC1) and Service Organization Controls (SOC2) audits. Help define remediation…
  • 3.1
    Spire Credit Union – Falcon Heights, Ramsey, MN
    $49k-$81k(Glassdoor est.)
    NEW
    alerts and/or complex claims to mitigate fraud losses. Assists in preparing for Credit Union exams, audits and compliance including… effectiveness of operations. Prepares reports summarizing findings and corrective action recommendations. Based on audit findings:…
  • 3.5
    Kelsey-Seybold – Pearland, TX
    6 days ago 6d
    design, configuration or support. Demonstrated knowledge of claims processing, vendor contracting, and benefit plan building.… Tapestry Configuration Analyst Location: Pearland Administrative Office Department: System Support Job Type: Full Time…
  • 2.9
    Cobius Healthcare Solutions – Chicago, IL
    $70k-$96k(Glassdoor est.)
    HOT
    billing, coding, reimbursement methodologies, claims denials, and payer audits Experience in all phases of software life cycle… be required. The Senior Business Analyst will apply expertise in revenue cycle operations and technology to help improve our…
  • 3.4
    CSAA Insurance Group – Henderson, NV
    $51k-$81k(Glassdoor est.)
    HOT
    Homeowner Claims Quality Assurance, Senior Analyst - Inside Requisition Number R2326 Homeowner Claims Quality Assurance… Homeowner Claims specialty. Performs analysis of data and claim files as part of ongoing quality assurance audit projects and…
  • 4.1
    Mutual of Omaha – United States
    5 days ago 5d
    reflective of the Sales Analyst essential functions, qualifications, and physical requirements. The Sr Sales Analyst level has variable… presentations to employer groups and policyholders on billings, claims, and enrollment procedures for various group employee programs…
  • 3.8
    Sharp HealthCare – San Diego, CA
    11 days ago 11d
    Experience in claims, customer service, and training preferred. Summary The Medical ClaimsAuditAnalyst is in direct… status or any other protected class. Keywords: Medical ClaimsAuditAnalyst
  • 4.8
    ELAP Services – Chesterbrook, PA
    EASY APPLY
    6 days ago 6d
    payment and operational efficiencies. The Physician Claim Reimbursement Analyst will perform all functions of ELAP’s audit process… this job The Physician Reimbursement ClaimAnalyst will be expected to serve as the subject matter expert (…
  • 3.5
    Johns Hopkins Health Care – Glen Burnie, MD
    $69k-$95k(Glassdoor est.)
    23 days ago 23d
    The Business Analyst - Code Auditing position reports to the Manager of Operations Business Support and is responsible for the… derivatives for business solutions for operations. The Business Analyst for code auditing will take responsibility for coordinating business…
  • 3.5
    Vaco Financial – Nashville, TN
    NEW
    of the audit process, including, without limitation, tracking audit notifications, reviewing and analyzing the claims contained… question is contractually permitted to audit; Assist in analyzing the auditclaims submitted by the auditor in question, as…
  • 4.1
    Mutual of Omaha – United States
    12 days ago 12d
    reflective of the Sales Analyst essential functions, qualifications, and physical requirements. The Sr Sales Analyst level has variable… presentations to employer groups and policyholders on billings, claims, and enrollment procedures for various group employee programs…
  • 4.3
    Johnsonville Sausage – Sheboygan Falls, WI
    11 days ago 11d
    conduct on site annual audits of the 3PL warehouse operations Assist in preparing annual capital and operating budgets for the individual… Posting 3PL Warehousing and OS&D Analyst Position Overview: The 3PL Warehousing and OS&D Analyst has responsibility for managing…
  • 3.7
    Zelis Healthcare – Bedminster, NJ
    $47k-$75k(Glassdoor est.)
    HOT
    The Senior Coding Research Analyst is responsible for conducting research relevant to claim edits for ZELIS clients, Medicare… and claims. Minimum 5+ years’ experience in direct patient care, medical procedure billing, medical insurance auditing, line…
  • 3.5
    Georgia Farm Bureau Insurance – Macon, GA
    $38k-$56k(Glassdoor est.)
    5 days ago 5d
    12/19/2017 Title Claims - OperationsAnalyst City Macon Description The ClaimsOperationsAnalyst is responsible for partnering… Actively initiate and perform periodic audits of closed claims files and other Claimsoperational areas to provide input to management…
  • 4.6
    The CRS Group – Chicago, IL
    12 days ago 12d
    ClaimsAnalyst Duration: 2 month contract Location: Chicago, IL Overview: The CRS Group is currently looking for a Claims Analyst… Functions: -Participates in claimsaudits and file reviews to ensure compliance with best practices in claims handling, TPA internal…
  • 3.1
    Synectics Inc. – Chicago, IL
    $37k-$58k(Glassdoor est.)
    12 days ago 12d
    ) · Participates in claimsaudits and file reviews to ensure compliance with best practices in claims handling, TPA internal… relationships with claims adjusters, insurers, legal counsel, and other claims related parties. · Responsibilities include claims monitoring…
  • 3.9
    Rose International – Chicago, IL
    13 days ago 13d
    Position Title: ClaimsAnalyst Position Number: 274300 Location: Chicago, IL Desired Skill Set: Claims, Insurance,… Functions: Participates in claimsaudits and file reviews to ensure compliance with best practices in claims handling, TPA internal…
  • 4.6
    CRS Group – Chicago, IL
    4 days ago 4d
    Functions: Participates in claimsaudits and file reviews to ensure compliance with best practices in claims handling, TPA internal… Job Description ClaimsAnalyst Duration: 2 month contract Location: Chicago, IL Overview: The CRS Group is currently…
  • 3.8
    Equian LLC – Franklin, TN
    $36k-$56k(Glassdoor est.)
    11 days ago 11d
    Position Summary: The ClaimsAnalyst (CA) is primarily responsible for meeting production and quality expectations. The CA will… will be responsible for auditingclaims while working independently to identify and secure payer refunds. The CA will also be responsible…
  • 3.5
    WellCare – Phoenix, AZ
    $39k-$59k(Glassdoor est.)
    20 days ago 20d
    Department:Arizona- OperationsClaims-Medicaid Reports to: Supv, Operations Location: E Camelback Rd, Phoenix AZ 85016… professional claims. Serves as a mentor to less experienced associates and acts as a resource to resolve more complex claims. Department…
  • 4.2
    Impossible Foods – Redwood City, CA
    24 days ago 24d
    restaurants across the United States. The Trade Promotion Analyst is a strategic business partner, who is responsible for providing… quick resolution. Reconcile general ledger accounts for open claims and un-cleared deductions. Identify, recommend and implement…
  • 3.5
    HCS Healthcare – Rancho Cucamonga, CA
    5 days ago 5d
    supervisor of the claims department, the Claims Auditor is responsible for the auditing of the company’s claims payment system and… Medicare claims Thorough understanding of HCFA regulations governing claims payment procedures Working knowledge of audit processes…
  • 3.2
    Inland Empire Health Plan – Rancho Cucamonga, CA
    5 days ago 5d
    PURPOSE: Under the direction of the Sr. Director of Claims, the Analyst I will provide research, project management and analytical… a project management role in the operational areas of claims or a related business operation. KNOWLEDGE/SKILLS REQUIRED:…
  • 3.5
    Duke Energy Corporation – Charlotte, NC
    4 days ago 4d
    regarding locates activity. Assist the Claims Department (along with Sr. Locates AuditAnalyst) with interpretation and supporting… a Locates AuditAnalyst and assists with the direct oversight of locate functions including billing, billing audits, historical…
  • 2.4
    Envision RX – Fort Lauderdale, FL
    $31k-$46k(Glassdoor est.)
    NEW
    [] ClaimsAnalyst The ClaimsAnalyst is responsible for reviewing, analyzing and reporting claims data and identifying claims… rejected and paid claims for discrepancies related to non-compliance of formulary, prior authorizations and audit criteria and report…
  • 3.5
    HSBC – Depew, NY
    $37k-$56k(Glassdoor est.)
    7 days ago 7d
    Fraud Risk - Fraud Claims and Recoveries - Provides reporting (MIS) and analysis related to Disputes Claims and Recovery NA. Maintains… . Serves as liaison to the Global Service Centers for Fraud Claims and Recovery functions. Manages internal projects and other…
  • 4.6
    Global Tax Management – Philadelphia, PA
    EASY APPLY
    $56k-$80k(Glassdoor est.)
    NEW
    supporting documents, and preparation / filing refund claims and audit appeals Communicate directly with State auditors, hearing… currently have a career opportunity for a SALT Senior Tax AnalystAudit Specialist in our State & Local Tax department. The successful…
  • 3.3
    UnitedHealth Group – Irvine, CA
    4 days ago 4d
    United Health Group, United Health Care, Claims, Processing, Customer Service, Analyst, Audit, Pharmacy, Medical… expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims Analyze and…
  • 2.5
    Atlas Air Worldwide – Los Angeles, CA
    $70k-$96k(Glassdoor est.)
    NEW
    company policies. Back up Sr. Marketing Operations Manager and Sr. Manager of Claims and Systems as needed during vacation and… related CargoSpot and Claims matter. Claims handling, processing and reporting systems to handle claims, upload documentation…
Page 1 of 19
Work in HR or Recruiting?