Remote Risk & Claims Lead: Audit & Compliance

Ladders; United States; Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Paid parental and caregiver leave

Short-term and long-term disability

Life insurance and wellness

Job summary

Ladders is seeking a Risk Management Lead to join our healthcare operations team. You will lead investigations into claim payment errors, manage audit responses, and drive corrective action planning.

You will partner with internal and external stakeholders to strengthen controls, translate contract requirements into operational practices, and mentor staff while guiding implementation workplans for key initiatives.

Qualifications

• 5+ years of experience in healthcare claims operations, audit, or compliance.
• Strong knowledge of reimbursement methodologies for Institutional and Professional claims.
• 2+ years of experience leading projects or teams.
• Experience resolving claim payment errors and audit findings.
• Proficiency in Microsoft Office, especially Excel, Word, and PowerPoint.

Responsibilities

• Lead investigations into alleged claim payment errors for audits.
• Train and mentor staff on audit preparation and documentation.
• Document root causes of errors and support corrective action planning.
• Collaborate with internal and external partners on audit findings.
• Provide expertise on high-dollar claims and their resolution.
• Translate contract requirements into operational processes and controls.
• Develop implementation workplans for projects and initiatives.

Skills

Healthcare claims operations

Audit/compliance

Team leadership

Root cause analysis

Mentoring/training

Excel/Office

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Ladders is seeking a Risk Management Lead to join our healthcare operations team. You will lead investigations into claim payment errors, manage audit responses, and drive corrective action planning.

You will partner with internal and external stakeholders to strengthen controls, translate contract requirements into operational practices, and mentor staff while guiding implementation workplans for key initiatives.