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To support the implementation of a new screening solution, the contract Property Management Specialist will manage light project tasks, audit application channels, and ensure data accuracy while working remotely.Key responsibilities:Support the...
To support the Sr. Director of Risk Actuarial Services, the full-time remote Medical Cost Projection Analyst will manage lifetime medical cost planning for injured workers, participate in process improvements for cost estimation, and conduct data...
To support the Content and Enablement team, the full-time Healthcare Content Solutions Analyst will focus on content optimization, dataset design, and ensuring compliance with healthcare policies while collaborating with cross-functional teams to...
To support the Pharmacy Network, the full-time remote Reimbursement Analyst will manage financial price modeling, analyze provider agreements, and ensure compliance with state MAC requirements while addressing pharmacy pricing inquiries.Key...
Working remotely in a full-time capacity, the Statistical & Claim Data Analyst will support statistical and actuarial initiatives through data analysis, technology solutions, and business consulting while partnering with business teams to optimize...
Working remotely on a full-time basis, the Medical Record Retrieval Specialist will collect, review, and manage medical records to support clinical reviews, quality programs, and regulatory audits while ensuring compliance with audit and privacy...
Responsible for conducting internal and external audits, the full-time remote Quality Assurance Examiner will analyze claims error data, document policies and procedures, and manage vendor interactions to ensure compliance and accuracy in claims...
To ensure the accuracy and compliance of healthcare claim payments across commercial, Medicare, and Medicaid lines of business, the full-time Payment Integrity Analyst will lead complex claim audits, develop claims editing rules, and monitor...
Providing essential administrative support, the full-time Audit Support Coordinator will assist the Coordination of Benefits and Data Mining teams by managing client communications, entering data accurately, and ensuring compliance with regulatory...
To support a client's team in Rockaway, New Jersey, the contract Compensation and Benefits Specialist will manage workers' compensation audits, investigate discrepancies in payroll and benefits data, and partner with HR to enhance compliance and...
Supporting comprehensive payroll and benefits operations, the full-time hybrid Virginia Payroll and Benefits Administrator will manage benefits programs, assist with payroll processing, and ensure compliance with relevant regulations while working...
To safeguard the organization, the full-time remote Compliance Administrative Assistant will manage compliance incidents, legal items, and insurance claims while monitoring incoming queues, assisting with employee onboarding, and executing monthly...
To safeguard the organization, the full-time remote Compliance Administrative Assistant will manage compliance incidents, legal items, and insurance claims while monitoring incoming queues, assisting with employee onboarding, and executing monthly...
Conducting fraud, waste, and abuse investigations, the full-time remote Fraud Investigations Analyst will lead quality control efforts, manage regulatory deliverables, and ensure compliance with Medicaid standards while preparing documentation for...
To support a growing team, the full-time hourly Billing Intake Specialist will assist members with initial file setup, manage balance bill inquiries, and ensure accurate data entry in a remote environment.Key responsibilitiesAssist members with...
Leading the analysis of healthcare utilization trends, the remote Principal Data Analyst (Healthcare Economics) will influence quality and cost outcomes while partnering with clinical and operational leaders to deliver actionable insights and...
Auditing inpatient facility coding for accuracy and compliance, the full-time Facility Inpatient Coding Auditor will work remotely to ensure adherence to coding guidelines and provide education and feedback to coding and QA teams.Key...
To support revenue optimization efforts, the full-time Revenue Integrity Specialist will manage reimbursement audits, ensure compliance with payer contracts, and collaborate with internal teams to enhance cash flow and payment accuracy.Key...
To support independent dispute resolutions, the part-time Maryland Licensed Coder Reviewer will conduct clinical documentation reviews, perform compliance audits, and generate detailed reports while working remotely.Key responsibilities:Conducting...
Serving as a strategic advisor and liaison, the full-time California Licensed Workers' Compensation Specialist will manage client relationships, oversee claims processes, and ensure compliance with state regulations while working remotely.Key...
To ensure compliance with coding standards, the full-time Outpatient Coding Auditor will conduct quality reviews and audits, provide educational feedback to coding staff, and identify documentation issues impacting coding accuracy.Key...
Conducting independent claims and vendor performance audits, the full-time remote Vendor Auditor will ensure compliance with contractual obligations and regulatory requirements while managing the organization's highest-risk vendor population.Key...
Seeking a detail-oriented Billing Compliance Auditor, this fully remote position will manage front-end pre-bill audits for insurance defense matters, perform line-by-line invoice reviews, and resolve billing discrepancies while collaborating with...
Working remotely in a full-time capacity, the Stop Loss Claims Auditor will manage claims examination, auditing, and processing while demonstrating proficient knowledge of Stop Loss processes and procedures.Key responsibilitiesAudit submitted...
Seeking a full-time Coding Compliance Auditor to work remotely, this position involves performing comprehensive audits of medical records, ensuring compliance with regulatory requirements, and providing education to improve coding quality across...
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