- AIG (Atlanta, GA)
- Claims , Quality Assurance Specialist - Worker's Compensation Join us as a Claims QA Specialist to make more of your specialist expertise and ... efficiency. How you will create an impact + Complete quality reviews on all files within program guidelines while...skill enhancement. What you'll need to succeed + Proven claims experience handling and auditing Workers Compensation… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a ... managed care service organization. This role involves auditing claims , identifying errors, and implementing corrective...improve overall claims accuracy and efficiency. The Claims Quality Specialist will work… more
- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
- University of Southern California (Alhambra, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating … more
- Genesis Healthcare (PA)
- …plans related to such issues. 5. Participates in provider monitoring and auditing activities and investigations, and implementing quality assurance and ... We are seeking a full time Certified Professional Coding Specialist to join our Advanced Care Organization (ACO) team....work as a compliance team member to ensure that claims submitted through participating LTC ACO TINs, including PAI… more
- Fairview Health Services (St. Paul, MN)
- …Qualifications** + 5 years hospital inpatient coding-related experience such as coding, auditing , abstracting, DRG assignment, Data Quality in coding denials + ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of...of hospital inpatient coding related experience such as coding, auditing , abstracting, DRG assignment, Data Quality in… more
- BrightSpring Health Services (Englewood, CO)
- …Inc. is a leading provider in home Infusion therapy. We are looking for a Billing Specialist to join our Revenue Cycle Management team as we grow to be one of the ... top home infusion providers in the country. The Billing Specialist will report to the Billing Manager and work...an industry shift from hospital delivery settings to lower-cost, high- quality alternative providers such as Amerita. As a core… more
- Baylor Scott & White Health (Temple, TX)
- …reviews, and reports on quality control activities for all Pharmacy Services Specialist 1 staff. Including review and auditing reports as determined by ... **JOB SUMMARY** The Pharmacy Services Specialist 2 communicates with members, providers, and clients...assist with understanding the prior authorization process, and resolve claims processing and eligibility issues while adhering to department… more
- Southern Glazer's Wine and Spirits (Lakeland, FL)
- …(Depots). This position will complement these teams with technical, data management, compliance, auditing , and tactical support. The EHS Specialist will serve as ... that truly cares about its people. **Overview** The EHS Specialist reports to the Director of EHS and supports...national programs, and corrective actions associated with our compliance auditing program. This role supports SGWS in achieving our… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Cannabis Management, Office of Title Program Specialist 1 (Cannabis) (NY HELPS) - VID 204701 Occupational Category Other Professional Careers ... City Albany State NY Zip Code 12226 Duties Description Reporting to a Program Specialist 2 (Cannabis), the Program Specialist 1 (Cannabis) position will be… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Cannabis Management, Office of Title Program Specialist 1 (Cannabis) - VID 204587 Occupational Category Other Professional Careers Salary Grade NS ... Reporting to the Deputy Director of Intergovernmental Affairs (NS), the Program Specialist 1 (Cannabis) position will be responsible for monitoring and interacting… more
- MyFlorida (Tallahassee, FL)
- REGULATORY SPECIALIST III - 79000228 Date: Dec 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 866424 Agency: Business and Professional Regulations Working Title: REGULATORY SPECIALIST III - 79000228 Pay Plan: Career Service Position Number: 79000228… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program ... rules and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining routine auditing… more
- Orlando Utilities Commission (Orlando, FL)
- …distributions, loans, hardships and compliance testing. + Assist in reviewing routine claims and auditing employee contributions and related payroll deductions; ... **,** is presently seeking a **Leave of Absence- Benefits Specialist ** to join the Employee Experience division. At OUC,...Prepare reports and support audits related to claims , leave requests, STD/LTD processes managed by third-party vendors.… more
- C&W Services (New York, NY)
- **Job Title** HSSE Regional Specialist **Job Description Summary** POSITION SUMMARY The Environmental Health & Safety (EH&S) Manager is responsible for providing ... report and manage the corrective actions * Support Workers Compensation (WC) claims tracking, investigation, and management process * Liaise with WC Program Manager… more
- Henry Ford Health System (Jackson, MI)
- …of their quality rewards program. o Maintains accurate record of specialist referral information, provider panel status by product line, and Network's criteria ... obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits… more
- Air Force Elements, US Transportation Command (Scott AFB, IL)
- …the Air Force Elements, US Transportation Command. As a Financial Management Specialist - Remediation Specialist (SYSTEMS) the incumbent will provide assistance ... accounting data and systems deficiencies. Responsibilities As a Financial Management Specialist at the GS-0501-7/9/11/12 some of your typical work assignments may… more
- US Coast Guard (Alexandria, VA)
- …Alexandria, Virginia. Responsibilities You will serve as a Supervisory IT Cybersecurity Specialist and be responsible for day-to-day operation of the A&A Department ... must be met by the closing date of this announcement. Qualification claims will be subject to verification. Basic Requirement: Individual Occupational Requirements… more
- Robert Half Accountemps (Nashua, NH)
- Description Nashua, NH - ON-SITE - Patient Access Specialist - 3rd Shift Position Hours 11:00am-7:00pm - Multiple Openings We are looking for a dedicated Patient ... Access Specialist to join our team in Nashua, New Hampshire....input benefit data to support billing processes and enhance claims accuracy. * Utilize software tools to identify potential… more
- Walden Security (Chattanooga, TN)
- … Quality Assurance initiatives, including record keeping, training and auditing . + Answers DOL unemployment inquiries and completes verification of employment ... in the filing of FMLA requests and Workers' Compensation claims . + Assists the Human Resources Manager with DOL...This job has no supervisory responsibilities. The Human Resources Specialist reports to the Human Resources Manager and is… more