Top 49 Claims analyst remote Jobs in Columbia Md

Payment Policy Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $58,320 - $115,830 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Mid-level
- 401(k)
Quick Apply
Claims Analyst - REMOTE
Ryder System —Annapolis, MD
- $90,000 - $100,000 a year
- Full-time
- Remote
- Bachelor's degree
- Experience equivalent to degree accepted
- Senior level
- Disability insurance
- Health insurance
Reimbursement Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $53,928 - $107,107 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Access
- Mid-level
Quick Apply
Clinical Analyst
Global Alliant Inc —Baltimore, MD
- Full-time
- Remote
- Mid-level
- Computer skills
- Communication skills
Quick Apply
9d
Quality Control Analyst - Level 2 (Remote)
FEI Systems —Columbia, MD
- Full-time
- Remote
- Computer science
- Computer Science
- Mid-level
Quick Apply
Business Analyst - Medicare Advantage Product Development (Remote)
Johns Hopkins Health Plans —Hanover, MD
- $28.90 - $47.71 an hour
- Full-time
- Remote
- Mid-level
- 3 years
- SQL
- Health insurance
Provider Contract Claims Analyst
Innovative Healthware Services, Inc. DBA ClaimsBridge —Arnold, MD
- $75,000 - $90,000 a year
- Full-time
- Microsoft Excel
- 5 years
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Finance and Accounting Analyst - Entry Level (Maryland)
US National Security Agency/Central Security Service —Fort Meade, MD
- $57,736 - $91,815 a year
- 8 hour shift
- Background check
- Microsoft Access
- Pass drug screening
3d
Senior Technical Analyst - FACETS (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $79,560 - $158,015 a year
- Full-time
- Remote
- Computer Science
- Customer service
- 5 years
- 401(k)
Quick Apply
7d
Program Manager - Pharmacy Supply Chain - (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $106,632 - $211,783 a year
- Full-time
- Remote
- Master's degree
- Analysis skills
- Bachelor's degree
- 401(k)
Quick Apply
Senior Medical Coding Specialist (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,464 - $133,991 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Presentation skills
- 401(k)
Quick Apply
Regulatory Operations & Mandates Project Manager IT (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $89,856 - $178,464 a year
- Full-time
- Remote
- Customer service
- Mid-level
- 3 years
- 401(k)
Quick Apply
Data Scientist
US Social Security Administration —Woodlawn, MD
- $143,913 - $187,093 a year
- Online Application
- Background check
- Pass drug screening
- System design
- Flextime
Test Automation Engineer
US Social Security Administration —Woodlawn, MD
- $143,913 - $197,200 a year
- Online Application
- Background check
- Azure
- Customer service
- Flextime
Collision Data Analyst
Advantage Surveillance LLC —Baltimore, MD
- $28.50 - $38.50 an hour
- Part-time
- ASE Certification
- Mid-level
- Analysis skills
Quick Apply
Inpatient Coding Auditor
Huron Managed Services LLC —Washington, DC
- $38.46 - $52.40 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Dental insurance
Quick Apply
1d
COBOL Developer
US Social Security Administration —Woodlawn, MD
- $143,913 - $197,200 a year
- Online Application
- Background check
- Pass drug screening
- System design
Test Automation Engineer III
eSimplicity —Columbia, MD
- $97,200 - $98,000 a year
- Full-time
- Remote
- Analysis skills
- Children
- Travel
- Paid holidays
- Disability insurance
Quick Apply
Data Solutions Developer
US Social Security Administration —Woodlawn, MD
- $143,913 - $187,093 a year
- Online Application
- Background check
- Pass drug screening
- System design
- Flextime
Solutions Architect
US Social Security Administration —Woodlawn, MD
- $143,913 - $197,200 a year
- Online Application
- Background check
- Pass drug screening
- System design
- Flextime

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claims analyst remote jobs near columbia md

Payment Policy Analyst (Remote)

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$58,320 - $115,830 a year

Benefits

401(k)

Qualifications

Managed care
Health insurance policy knowledge
Policy analysis
Internal employee customer service

Full Job Description

Resp & Qualifications

PURPOSE:
The Payment Policy Analyst will research, develop, and coordinate the distribution and maintenance of payment policies in support of corporate payment methodologies, provider contracts, claims adjudication rules, and applicable regulatory and industry standards. This role applies analytical skills and subject matter knowledge to evaluate the impact of payment policies and ensure accurate implementation. We are looking for experienced professionals to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.

ESSENTIAL FUNCTIONS:

Performs in-depth research on topics identified as actual or potential payment policies. Evaluates CMS guidance, industry references, peer health plan policies, coding conventions, and other authoritative sources to determine appropriateness for policy development. Assesses and communicates the operational, financial, and provider impact of payment policy decisions.
Writes evidence-based payment policies and operating procedures related to reimbursement methodologies, coding and billing rules, legislative and regulatory mandates, contractual provisions, and corporate payment philosophy to ensure consistent application across all lines of business.
Maintains the Payment Policy Reference Manual (PPRM), including resource files and supporting documentation. Ensures dissemination of payment policies and procedures to implementation teams (e.g., claims, configuration, provider operations) and other appropriate departments. Ensures maintenance and accuracy of online policy content, responds to business inquiries, and provides written clarification of existing and emerging payment policies and trends.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Health Administration, Business, Finance, Nursing or related discipline 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 Upon Hire Required:

Certified Coder (CCS or CPC)-AHIMA or AAPC AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS).

Experience: 3 years experience in payment policy, reimbursement policy, claims configuration, billing rules, and/or coding guidelines in a health care or health plan setting.

Preferred Qualifications:

Advanced knowledge of CPT, HCPCS, ICD-10-CM/PCS coding systems and claims reimbursement rules.
Experience in technical writing, reimbursement methodologies, health economics or statistics.

Knowledge, Skills and Abilities (KSAs)

Ability to analyze complex information, make sound decisions, and resolve policy-related issues.
Demonstrated ability to work collaboratively across operational and technical teams.
Strong written and verbal communication skills, including ability to present to internal stakeholders at all levels.
Use of Microsoft Office applications (Excel, PowerPoint, Word).
Working knowledge of medical insurance and managed care principles.
Knowledge of fee schedules, payment methodologies, bundling logic, modifiers, and places of service.
Knowledge of standardized processes for evaluating payment support operations and claims adjudication practices.

Salary Range: $58,320 - $115,830

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

Health 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.

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-SS1

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Refine Your Search

claims analyst remote jobs in columbia md

Payment Policy Analyst (Remote)

Claims Analyst - REMOTE

Reimbursement Analyst (Remote)

Clinical Analyst

Quality Control Analyst - Level 2 (Remote)

Business Analyst - Medicare Advantage Product Development (Remote)

Provider Contract Claims Analyst

Finance and Accounting Analyst - Entry Level (Maryland)

Senior Technical Analyst - FACETS (Remote)

Program Manager - Pharmacy Supply Chain - (Remote)

Senior Medical Coding Specialist (Remote)

Regulatory Operations & Mandates Project Manager IT (Remote)

Data Scientist

Test Automation Engineer

Collision Data Analyst

Inpatient Coding Auditor

COBOL Developer

Test Automation Engineer III

Data Solutions Developer

Solutions Architect

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