Remote Healthcare Claims QA & Training Specialist

Ex; United States; Remote; USD 75,000 - 90,000; Full time

Job summary

Ex is seeking a detail-oriented auditor to review completed audit findings, validate overpayment opportunities, and ensure alignment with client requirements, coding guidelines, pricing rules, and claim payment methodologies.

The ideal candidate brings healthcare claims knowledge, strong analytical thinking, and the ability to deliver virtual training and clear feedback to improve auditor performance, recovery outcomes, and continuous improvement.

Qualifications

• Knowledge of healthcare claims processes and guidelines.
• Experience applying coding guidelines, pricing rules, and claim payment methodologies.
• Ability to design training plans and learning resources.

Responsibilities

• Review audit findings and validate overpayment opportunities.
• Ensure repricing accuracy and supporting documentation.
• Provide coaching and virtual training to auditors.

Skills

Healthcare claims

Analytical thinking

Attention to detail

Virtual training

Communication skills

Feedback coaching

Job description

Ex is seeking a detail-oriented auditor to review completed audit findings, validate overpayment opportunities, and ensure alignment with client requirements, coding guidelines, pricing rules, and claim payment methodologies.

The ideal candidate brings healthcare claims knowledge, strong analytical thinking, and the ability to deliver virtual training and clear feedback to improve auditor performance, recovery outcomes, and continuous improvement.