Auditor (Remote)
Baltimore, MD · Remote
Certified Internal Auditor (CIA) * Certified Public Accountant (CPA) * Certified Fraud Examiner ... health care industry. Preferred Qualifications: * Preferred that individual possess or is in the ...
Baltimore, MD · Remote
Certified Internal Auditor (CIA) * Certified Public Accountant (CPA) * Certified Fraud Examiner ... health care industry. Preferred Qualifications: * Preferred that individual possess or is in the ...
Baltimore, MD · Remote
Certified Internal Auditor (CIA) * Certified Public Accountant (CPA) * Certified Fraud Examiner ... health care industry. Preferred Qualifications: * Preferred that individual possess or is in the ...
Tampa, FL · On-site +1
Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... At least 3-5 years of Quality Analyst in healthcare, TPA, or health plan settings/ healthcare ...
Tampa, FL · On-site +1
Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... At least 3-5 years of Quality Analyst in healthcare, TPA, or health plan settings/ healthcare ...
Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims ...
Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor ... At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims ...
Salary: Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims ... At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims ...
Quick apply
Salary: Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims ... At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims ...
Remote Auditor Remote Regular (US Only) MERIEUX NUTRISCIENCES As a trusted partner, our Public Health mission is to make food systems safer, healthier and more sustainable. Throughout our global ...
Remote Auditor Remote Regular (US Only) MERIEUX NUTRISCIENCES As a trusted partner, our Public Health mission is to make food systems safer, healthier and more sustainable. Throughout our global ...
Franklin, TN · On-site +1
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns ... Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS ...
Franklin, TN · On-site +1
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns ... Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS ...
$60 - $80/hr
Remote Contract Auditor Remote Regular (US Only) MERIEUX NUTRISCIENCES As a trusted partner, our Public Health mission is to make food systems safer, healthier and more sustainable. Throughout our ...
$60 - $80/hr
Remote Contract Auditor Remote Regular (US Only) MERIEUX NUTRISCIENCES As a trusted partner, our Public Health mission is to make food systems safer, healthier and more sustainable. Throughout our ...
Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and ... compliance activities related to risk adjustment data submitted to CMS. In this role, you will ...
Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and ... compliance activities related to risk adjustment data submitted to CMS. In this role, you will ...
Carmel, IN · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Carmel, IN · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Boston, MA · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Boston, MA · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
$28 - $31.75/hr
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and ... Together. This is a remote position. The MRA Coding Auditor supports departmental Quality ...
$28 - $31.75/hr
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and ... Together. This is a remote position. The MRA Coding Auditor supports departmental Quality ...
Chicago, IL · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Chicago, IL · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Atlanta, GA · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Atlanta, GA · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Carmel, IN · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
Carmel, IN · On-site +1
$67K - $100K/yr
... and health insurance, annuities, financial services, and workforce benefits to more than 3.3 ... Professional certifications such as Certified Information Systems Auditor (CISA), Certified ...
$45K - $55K/yr
Competitive Benefits - Health Insurance, Dental, 401k and FSA/HSA * Holiday Pay * Vacation Pay Total Compensation per year $45k to $55k Responsibilities Complete audits for Property & Casualty ...
$45K - $55K/yr
Competitive Benefits - Health Insurance, Dental, 401k and FSA/HSA * Holiday Pay * Vacation Pay Total Compensation per year $45k to $55k Responsibilities Complete audits for Property & Casualty ...
Eden Prairie, MN · On-site +1
$24 - $43/hr
The work you do with our team will directly improve health outcomes by connecting people with the ... This role will provide coding quality auditing services to ensure compliance with Optum and CMS ...
Eden Prairie, MN · On-site +1
$24 - $43/hr
The work you do with our team will directly improve health outcomes by connecting people with the ... This role will provide coding quality auditing services to ensure compliance with Optum and CMS ...
Eden Prairie, MN · Remote
$24 - $43/hr
The work you do with our team will directly improve health outcomes by connecting people with the ... This role will provide coding quality auditing services to ensure compliance with Optum and CMS ...
Eden Prairie, MN · Remote
$24 - $43/hr
The work you do with our team will directly improve health outcomes by connecting people with the ... This role will provide coding quality auditing services to ensure compliance with Optum and CMS ...
Arkansas City, AR · Remote
$63K - $87K/yr
Isite Technologies Inc is seeking a passionate and dedicated Behavioral Health Clinician to join our remote team. In this role, you will provide vital support to individuals navigating mental health ...
Quick apply
Arkansas City, AR · Remote
$63K - $87K/yr
Isite Technologies Inc is seeking a passionate and dedicated Behavioral Health Clinician to join our remote team. In this role, you will provide vital support to individuals navigating mental health ...
Essential Job Duties Performs audits in care management, member assessment, behavioral health, and ... Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ...
Essential Job Duties Performs audits in care management, member assessment, behavioral health, and ... Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ...
... safer, healthier and more sustainable. From the food you eat, to the water you drink, to the ... As a lead auditor, the role will involve managing and developing social compliance auditors - in ...
... safer, healthier and more sustainable. From the food you eat, to the water you drink, to the ... As a lead auditor, the role will involve managing and developing social compliance auditors - in ...
$33K - $41K
2% of jobs
$41K - $49.1K
17% of jobs
$53.3K is the 25th percentile. Wages below this are outliers.
$49.1K - $57.1K
12% of jobs
$57.1K - $65.2K
11% of jobs
The median wage is $69.5K / yr.
$65.2K - $73.2K
17% of jobs
$73.2K - $81.3K
7% of jobs
$81.3K - $89.3K
6% of jobs
$89.3K - $97.4K
3% of jobs
$97.5K is the 75th percentile. Wages above this are outliers.
$97.4K - $105.4K
17% of jobs
$105.4K - $113.5K
4% of jobs
$113.5K - $121.5K
4% of jobs
$33K
$76.3K
$121.5K
| Aspect | Behavioral Health Auditor Remote | Behavioral Health Claims Reviewer |
|---|---|---|
| Required Credentials | Certification in auditing or healthcare compliance, relevant licenses | Knowledge of insurance policies, basic healthcare certifications |
| Work Environment | Remote, independent auditing tasks, data analysis | Remote or onsite review of insurance claims, documentation |
| Employer & Industry Usage | Healthcare organizations, insurance companies, government agencies | Insurance companies, third-party administrators, healthcare providers |
Behavioral Health Auditor Remote and Behavioral Health Claims Reviewer roles both involve working with healthcare data remotely. Auditors focus on evaluating compliance and accuracy of behavioral health records, while claims reviewers primarily assess insurance claims for correctness. Both roles require knowledge of healthcare regulations and often share similar certifications, making them comparable in the behavioral health industry.
7.3
Based on 31 frontline employees who took The Breakroom Quiz
219th of 281 rated insurance
Resp & Qualifications
PURPOSE:
Assess the organization's operational, financial, regulatory and compliance controls to ensure processes function efficiently and remain in compliance with CareFirst policies, procedures and regulations. Evaluates internal control processes to identify potential control deficiencies. Report audit findings to the supervisor or manager and recommend solutions to improve overall processes and control governance.
ESSENTIAL FUNCTIONS:
QUALIFICATIONS:
Education Level: Bachelor's Degree in Business Administration, Management Sciences, Finance, Accounting or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
Licenses/Certifications Preferred:
Experience: 1 year Experience in accounting, finance, auditing, insurance or relevant work experience in an operational capacity in the health care industry.
Preferred Qualifications:
Knowledge, Skills and Abilities (KSAs)
Salary Range: 50,904 - 101,101
Travel Requirements
Estimate Amount: 5% Travel to various CareFirst offices, vendor locations, and training facilities.
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Department
Audit and Advisory Services
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
#LI-LJ1
Get the full story on Breakroom