$66K - $114K *
Unlock potential by applying actuarial analysis to develop and validate data. Collaborate in updating pricing and forecasting models while ensuring data accuracy, all under limited supervision in a fl...
Today
Medical Review Auditor (Fraud Waste and Abuse)
$70K - $91K *
Lead the charge in auditing medical records for accurate coding compliance and health plan policies. Prepare detailed reports, conduct relevant research, and maintain knowledge of healthcare guideline...
2 weeks ago
$77K - $127K *
Transform revenue analytics by leveraging your actuarial expertise to complete complex studies, enhance reporting accuracy, and drive strategic financial insights, all while collaborating closely with...
Today
Auditor Clinical Validation DRG
$95K *
Empower the auditing process by analyzing inpatient claims and ensuring coding accuracy. Leverage your clinical expertise and advanced coding knowledge to drive quality and productivity in chart valid...
5 days ago
Content Analyst II - Drug and Biological Policy
$100K - $125K *
Join a dynamic clinical operations team, driving quality assurance and policy maintenance for Drug and Biological policies. Your expertise will enhance our coding processes and support client inquirie...
2 weeks ago
$95K - $115K *
Help us analyze and optimize medical policies while providing key insights across clinical operations. Collaborate with teams to ensure effective policy development and quality assurance, enhancing ou...
6 days ago
$94K - $170K *
Support innovative pricing strategies and regulatory compliance while developing complex rating models for Individual and Small Group ACA products. Collaborate with teams to drive strategic initiative...
4 days ago
$94K - $156K *
Unlock potential by leading complex actuarial projects, analyzing risk contracts, and supporting Medicare pricing strategies. Collaborate with a dynamic team to drive innovative solutions and enhance...
1 week ago
$89K - $170K *
Drive comprehensive actuarial analysis by managing complex projects, training analysts, and implementing risk contracts to support innovative capitation initiatives. Collaborate in a hybrid environmen...
2 weeks ago
$70K - $95K *
Transform business needs into effective application requirements. Collaborate with teams to analyze and enhance systems, ensuring user alignment and comprehensive testing. Drive impactful solutions th...
Today
Auditor Clinical Validation Outpatient Specialty Clinical
$95K *
Unlock your potential by auditing outpatient claims. Leverage your clinical and coding expertise to enhance accuracy and improve treatment quality while contributing to innovative auditing solutions i...
2 weeks ago
Claims Manager- Commercial Auto Excess Casualty
$100K - $130K *
Lead a high-performing team of commercial auto claims specialists, ensuring technical excellence and operational efficiency in managing complex excess casualty claims while leveraging data-driven stra...
Reposted 3 weeks ago
$70K - $95K *
Support a team that evaluates and manages construction claims, ensuring effective strategies for investigation, negotiation, and resolution, while communicating findings with stakeholders and adapting...
1 week ago
$75K - $100K *
Join a dynamic team driving claims operations and reporting! Manage claim processes, enhance data quality, and implement continuous improvements to deliver reliable insights for leadership and carrier...
3 weeks ago
Complex Denials Consultant (Complex Claims)
$90K - $112K *
Unlock potential by guiding healthcare providers through complex claims disputes. Represent clients in WC, MVA, TPL, and VA claims while ensuring compliance with state laws. Collaborate with teams to...
1 week ago
Senior Claims Consultant, National Accounts
$92K - $154K *
Shape the future of claims management by leading strategy for large accounts, providing analytics and insights, and fostering strong relationships with clients and stakeholders for optimal claim resol...
2 weeks ago
Senior Analyst, Rebate and Audit - SMC
$88K - $110K *
Champion financial rigor by executing advanced analyses for rebate contracts, driving process optimization, and collaborating with cross-functional teams to enhance client relations and contract manag...
3 weeks ago
$66K - $100K *
Join a team that's driving efficiency in claims operations by resolving complex system issues, improving workflows, and delivering user training. Collaborate with IT and help desk teams to enhance pro...
1 week ago
$100K - $130K *
Champion proactive claims management by serving as a trusted advisor, partnering with clients and stakeholders to drive optimal outcomes in the insurance claims lifecycle across multiple coverage line...
1 week ago
Major Case Unit Claims Adjuster, Courier Delivery
$70K - $95K *
Drive the resolution of complex major case claims involving serious injuries. Take ownership of the entire claims lifecycle while collaborating with stakeholders to achieve timely outcomes through eff...
2 weeks ago
Auditor DRG Validation (CMS Audits)
$95K *
Analyze and audit inpatient DRG claims by applying coding expertise to enhance accuracy and ensure compliance. Collaborate on process improvements to drive operational excellence in a dynamic healthca...
1 week ago
$75K - $95K *
Elevate your career by managing complex insurance claims while providing exceptional service. As a strategic thinker, develop relationships with clients and colleagues, ensuring swift resolutions and...
Reposted 6 days ago
Claims Examiner, Commercial Trucking | Bodily Injury | Remote
$80K - $85K *
Join our team to analyze and process complex auto and commercial transportation claims, ensuring accurate investigations, liability determinations, and timely resolutions to support our clients and in...
1 week ago
Quality Analyst - Outpatient, Healthcare
$85K - $92K *
Empower healthcare quality as a detail-oriented Outpatient Quality Analyst. Mentor coding teams, ensure compliance, and drive process improvements in a dynamic remote environment, making a meaningful...
2 weeks ago
Workers Compensation Claims Examiner | SIP Required
$80K - $100K *
Unlock potential by expertly managing complex workers' compensation claims, ensuring timely resolutions while collaborating with clients and vendors. Engage in a rewarding role focused on innovative s...
1 week ago