Claims Quality Auditor jobs in the United States
Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Quality Auditor jobs
- Teksystems LLC
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Los Angeles, CA
FULL_TIME
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Job Description
This is a full-time on-site role for a Claims Auditor.
The Claims Auditor will be responsible for auditing claims, utilizing analytical skills to investigate discrepancies, and auditing medical claims.
- This position is responsible for maintaining routine auditing functions and providing feedback on departmental activities, to assure compliance with all health plan and regulatory agencies, including CMS, DMHC (Department of Managed Health Care), and DHS.
- This position includes the responsibility for routine hospital and professional audits, complex audits on individual or random training, and focused claims to identify exceptions to established claims adjudication requirements for claims processing, payment and procedural accuracy.
- In addition, this position is responsible to assist with eligibility identify (e.g. COB, ESRD) and Letters of Agreements as required.
- To maintain in strict confidence, all member, provider, and Health Plan information to which Claims Auditing Specialist has access.
Apply here, or email resumes to: agrove@teksystems.com
- 5 Days Ago
- American Benefit Corporation
-
Ona, WV
FULL_TIME
- American Benefit Corporation is looking to add a detail-oriented, master multi-tasker to our team! Looking for a job with competitive pay and superb benefits? If your organizational skills are on poin...
- 9 Days Ago
- Starr Companies
-
Atlanta, GA
FULL_TIME
- Starr Insurance Companies is a leading insurance and investment organization, providing commercial property and casualty insurance, including travel and accident coverage, to almost every imaginable b...
- 1 Day Ago
- IntePros
-
Philadelphia, PA
CONTRACTOR
- IntePros is seeking a Claims Auditor to participate in pre- and post-implementation audits of client benefits and setup! This role focuses on preparing claims test scenarios and performing group setup...
- 15 Days Ago
- Innovative Management Systems Incorporated
-
City of Industry, CA
FULL_TIME
- DescriptionTHE POSITION.This position is responsible for reviewing and processing claims, including facility claims, to ensure accuracy prior to payment release. This position is the lead responder to...
- 27 Days Ago
- COMMUNITY HEALTH GROUP
-
Chula Vista, CA
OTHER
- Job Details Job Location: Corporate Headquarters - Chula Vista, CA Position Type: Full Time Education Level: 2 Year Degree Salary Range: $24.10 - $27.71 Hourly DescriptionEEO-1: Administrative Support...
- 1 Month Ago
Claims Quality Auditor jobs at Popular Companies
- Department Of The Interior
-
Washington, DC
- Summary The Government Wide direct hire authority for Physical Sciences is being used to fill this position. Salary for ...
- 12/12/2024 12:00:00 AM
- DGCI Corporation
-
Mc Lean, VA
- National Management Solutions, (NMS), a wholly owned subsidiary of DGCI Corporation, (DGCI), seeks a Data Quality Specia...
- 12/11/2024 12:00:00 AM
- Capital One
-
Mc Lean, VA
- Center 1 (19052), United States of America, McLean, Virginia Audit Manager, Practices- Quality Assurance (Hybrid) **Capi...
- 12/11/2024 12:00:00 AM
- Aramark Corp.
-
Washington, DC
- Job Description The Food & Occupational Safety Manager at the Georgetown University Aramark account will coordinate effo...
- 12/11/2024 12:00:00 AM
- TAMKO
-
Frederick, MD
- Summary To perform this job successfully an individual must be able to perform each essential function satisfactorily.Re...
- 12/9/2024 12:00:00 AM
- E2 Optics
-
Ashburn, VA
- E2 Optics is an award-winning, Woman-Owned technology integrator, headquartered in Denver, Colorado. We help clients dep...
- 12/8/2024 12:00:00 AM
- X-Energy
-
Rockville, MD
- X-energy LLC conducts a thorough recruiting process and will never issue offers without interview to discuss qualificati...
- 12/8/2024 12:00:00 AM
- Micron Technology
-
Manassas, VA
- Our vision is to transform how the world uses information to enrich life for all. Micron Technology is a world leader in...
- 12/8/2024 12:00:00 AM