- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Claims Quality Review Auditor is HYBRID position accountable for auditing various claims to ensure quality and accuracy to ... and procedures and regulatory guidelines. Makes recommendations to improve quality , workflow processes, policies and procedures. **ESSENTIAL FUNCTIONS OF THE… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Quality Auditor II Job Category:...researches on complex claims problems. Duties Performs high quality review of payable and post payment ... net required to achieve that purpose. Job Summary The Claims Quality Auditor II works...changing work environment. Perform random review of claims audited by the Quality Control Examiners… more
- JBS USA (Greeley, CO)
- **Description** Claims Auditor Purpose and Scope/General Summary: We are looking for a Claims Auditor for our Fed Beef division. This role will sit at ... our Corporate office in Greeley, CO. The Claims Auditor responds to notifications of discrepancies...These notifications may be in regard to product integrity, quality , damage and/or count discrepancies. It is the role… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, September 9, 2024 Centers Plan for Healthy Living's goal is to create the ... their use and identifying any deficiencies. + Prepare summaries for management of quality review results, including basic analysis of identified trends. +… more
- Rising Medical Solutions (Chicago, IL)
- …born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment. Join ... + Consistently meet productivity and turn-around time requirements. + Adhere to quality standards, state billing guidelines, HIPAA rules, and confidentiality of all… more
- State of Colorado (Denver, CO)
- Risk Mitigation Auditor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4656593) Apply Risk Mitigation Auditor Salary $70,140.00 - ... CO Job Type Full Time Job Number KAA 9570 Auditor III 9.24 MR Department Department of Labor and...who exhibit our shared values and our passion for quality and excellence in all we do. In addition… more
- Fallon Health (Worcester, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Elevance Health (Indianapolis, IN)
- …lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by ... **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid...processes and processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …ensuring coding accuracy, coding consistency and efficiency in filing of inpatient claims . Collaborates with the Clinical Documentation Quality Liaison to assist ... as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for… more
- Elevance Health (Indianapolis, IN)
- … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG (DIAGNOSTIC RELATED GROUP) CODING AUDITOR ** **Location** : This position will work a...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- Crawford & Company (Fresno, CA)
- Excellence In Everything We Touch Position Summary + Looking for California State Auditor for our CA Workers Compensation Claims Division! + Candidate must have ... experience as CA Claims Adjuster/Examiner! + CA Designation is not a requirement!...+ Multiple Employee Discounts! Ensures that clients receive a quality work product by adhering to the established standards… more
- Elevance Health (Columbus, OH)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will ... **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid...and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation… more
- Hackensack Meridian Health (Hackensack, NJ)
- …** at **Hackensack Meridian** **_Health_** includes: + Assist with developing coding quality improvement initiatives. + Analyze, review and resolve coding and ... a leader of positive change. The **Ambulatory Payment Classification (APC) Auditor ** performs all related internal, concurrent, prospective and retrospective coding… more
- National Vision (Duluth, GA)
- …with source documents for data accuracy and systematically records the results of their quality review for the purpose of providing feedback for focused ... to live their best. We help people by making quality eye care and eyewear more affordable and accessible....reality. National Vision is hiring a Managed Care QA Auditor to join our growing team! The role is… more
- Reyes Holdings (San Leandro, CA)
- …quality -related issues. This position focuses on compliance through capability building. The Quality Assurance Manager oversees the review and mitigation of ... to the rule governing the program. Position Summary: The Quality Assurance Manager is the subject matter expert for...management for decision making during a crisis situation + Review audit results and identify the severity of audit… more
- LMI Aerospace (Washington, MO)
- …regarding quality . This may entail technical responses to written claims and complaints, on-site visits to customer facilities, negotiation with customer ... Ensure that document control procedures are utilized to approve, review and update all changes to critical documents within...6 Sigma an advantage, but not essential + Trained quality systems auditor highly preferred WHY CHOOSE… more
- Saint-Gobain (Williamsport, MD)
- The Quality Control Supervisor is responsible for overseeing and monitoring the inspection, testing, and performance of products manufactured at the Williamsport, MD ... plant to ensure adherence to established quality standards. **Supervision** + Responsible for staffing, mentoring, and developing the Quality Control team. +… more
- The Diez Group (Dearborn, MI)
- Quality Engineer Dearborn, MI (http://maps.google.com/maps?q=8111+Tireman+Ave+Dearborn+MI+USA+48126) Description Summary/Objective April Steel Processing, is ... currently seeking an individual who is passionate about quality improvement in manufacturing environments with knowledge of ISO and IATF 16949 requirements. The … more
- Immigration and Customs Enforcement (IN)
- …standard. Similarly, "accountant" should be interpreted, generally, as "accountant and/or auditor .") OR Combination of education and experience: at least 4 years ... in accounting or auditing courses of appropriate type and quality . This can include up to 6 hours of...certificate as Certified Public Accountant or a Certified Internal Auditor , obtained through written examination; or Completion of the… more
- Patent and Trademark Office (Alexandria, VA)
- …knowledge of financial management, fiscal, and accounting theories to review , analyze, and evaluate accounting and financial management systems. Responsibilities ... revenue, intra-governmental and intra-Commerce, leases, fiduciary, budgetary reporting, contingent claims , related fluctuation analyses, and other financial functions. Requirements… more