The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers... CQA auditor will coordinate Health Plan’s audits activities with preparation and provide preliminary results on non...
is improving health outcomes for consumers, patients, healthcare professionals, employers and employees. Reporting to the Quality... and Clinical manager, you will act as a leader and influencer of quality case management. You will support case manager development...
every day. Job Overview The Claims Auditor will be responsible for the accurate review and auditing of claims... that are adjudicated by the system and the Claims Examiners. The auditor will suggest process improvements to management and act...
Auditor III Claims is responsible for audits of claims processed by Delegated Participating Physician Groups (PPGs), hospitals.... Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income...
Anticipated End Date: 2025-10-24 Position Title: Claims Auditor II Job Description: Claims Auditor II Location... is granted as required by law. The Claims Auditor II is responsible for audits of high dollar claims across the stop loss...
Anticipated End Date: 2025-10-24 Position Title: Claims Auditor Senior Job Description: Claims Auditor Senior... is granted as required by law. The Claims Auditor Senior is responsible for auditing of high dollar claims across the stop loss...
Anticipated End Date: 2025-10-24 Position Title: Claims Auditor I Job Description: Claims Auditor I Location... is granted as required by law. The Claims Auditor I is responsible for pre and post payment and adjudication audits of high...
Specialty Health Plans Auditor, Claims – Remote Pay: $131,040 – $137,280 annually Location: Remote (California... a Specialty Health Plans Auditor III to support their financial compliance and audit functions. In this role, you’ll conduct...
The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers... CQA auditor will coordinate Health Plan’s audits activities with preparation and provide preliminary results on non...
every day. Job Overview The Claims Auditor will be responsible for the accurate review and auditing of claims... that are adjudicated by the system and the Claims Examiners. The auditor will suggest process improvements to management and act...
, apply today! Overview: The primary purpose and function of the Auditor, Insurance Claims is to adjudicate, re-bill and rebut insurance... years of related experience. Prior experience as a claims auditor within a group practice environment. Knowledge/Skills...
. Additional Information: The Claim Auditor I is responsible for auditing behavioral and medical claims and ensuring quality... metrics are met by conducting post claims reviews on posted claims for Texas Medicaid and CHIP programs. The Claim Auditor...
organization. Let’s be better together. Position Summary Provides accurate quality assurance auditing of post-payment claims... committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering...
Description : The Claims Quality Assurance serves as the claim technical expert for the Claims Operations by auditing... on these to senior leadership of assigned offices. Support the Claims Quality Assurance Program and the EC Operations team...
Auditors also provide coaching and work closely with business leaders to drive optimal results. The Quality Assurance Auditor...Job Category: Customer Services and Operations Job Description: Your Role The Quality Review team completes...
) Standard Weekly Hours: 40 Summary: The Billing Auditor - Quality Assurance reviews, audits, and validates the accuracy..., medical documentation review, claims auditing, or revenue cycle auditing experience in a healthcare setting...
what's possible for a sustainable world. Position Description As a Trane quality braze auditor, your main duties are to inspect connections, braze... and/or inspection reports and assessments, and develop quality control monitoring protocols. The person who accepts this role will begin...
Overview: About the Role The main role of the Inpatient Coding Data Quality Auditor/Educator is to support accurate... processing of inpatient claims and data collection. Optimize Diagnosis-Related Group (DRG) reimbursement. Produce high-quality...
Overview About the Role The main role of the Inpatient Coding Data Quality Auditor/Educator is to support accurate... processing of inpatient claims and data collection. Optimize Diagnosis-Related Group (DRG) reimbursement. Produce high-quality...
of improving the health of our communities. About the Role: Job Summary Coding Education & Quality Auditors (CEQA) conduct... and resource on interpretation and application of documentation and coding rules and regulations. CEQAs assure the quality of the...