Claims Quality Auditor jobs in Atlantic City, NJ
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
RN - Progressive Care Unit
- Quality Clinicians
-
Lewes, DE
FULL_TIME
-
**Position: Registered Nurse (RN)**
**Summary:**
This position is responsible for the direct and indirect nursing care of the unit patient. The role requires knowledge of departmental and hospital policies relevant to the delivery of nursing care. Interpretive skills and frequent interactive and consultive associations are inherent in this position.
**Responsibilities:**
- Facilitates, implements, and evaluates the Patient Plan of Care and outcomes.
- Collaborates with the healthcare team to promote positive patient outcomes.
- Serves as a patient advocate.
- Timely implementation of nursing interventions.
- Demonstrates appropriate clinical skills and technical competence in providing patient care.
- Exercises appropriate clinical judgment.
- Assesses, analyzes, and communicates patient information in a timely manner.
- Accurately and promptly documents all patient assessments, interventions, responses, and provider communication.
- Assesses patient safety risk factors and identifies those requiring specific safety interventions.
- Follows medication safety policy.
- Promptly initiates appropriate interventions for safety needs.
- Completes Safety Tracking Tools as required.
- Supervises assigned staff and delegates appropriately.
- Takes responsibility for all care provided to patients assigned.
- Reports all performance issues of team members to ensure all patients receive appropriate care and attention.
- Assesses educational needs of patients and provides appropriate written and verbal instructions.
- Documents assessment and education provided.
- Performs ongoing review, initiation, and implementation of patient orders in a timely manner every shift.
- Prioritizes responsibilities and issues, taking into account urgency and patient needs.
- Seeks appropriate resources.
- Problem solves independently.
- Multitasks efficiently and demonstrates effective time management skills.
- Actively seeks out other clinical experiences to enhance knowledge base.
- Actively assists others and accepts additional duties or assignments.
- Completes assigned education and annual competencies in a timely manner.
- Actively engages in unit-based councils and performance improvement.
- Recognizes unit needs and works to help facilitate solutions.
**Requirements:**
- Education: RN Diploma/RN Graduate Program
- Credentials: RN - Registered Nurse, BLS - Basic Life Saving certification, ACLS - Advanced Cardiac Life Support, NIH - Stroke Certification
- Experience in Hospital or Acute Care Setting (preferred)
- Graduate of an accredited School of Nursing (Bachelor's degree preferred)
- 2 years nursing experience caring for Step Down level of care patients, including cardiothoracic surgery patients (preferred)
- Ability to perform CPR
- ACLS and BLS certification
- NIH certification
- PCCN certification within 2 years of start date
- Clinical Ladder within 2 years of start date
- Cardiac Surgery Certification (CSC) within 3 years of start date
- CSU-ALS Certification within 3 years of start date
- Current licensure as a Registered Nurse in the State of Delaware
- Clear communication skills, both written and verbal
- Ability to keep confidential information regarding patients and team members
- Ability to withstand crisis situations
- Provides customer service to patients, team members, and visitors
- Knowledge and experience with Electronic Health Record
- On-call: None
- Weekend availability required
**Benefits:**
- Health Insurance is available to team members on the first of the month after completing 30 days of employment.
- All other benefits start on the first of the month after completing 90 days of employment.
- PTO
- Long-Term Sick Bank
- Health Vision Dental
- Basic Life Insurance
- Supplemental Life Insurance
- Retirement Plus (403B)
- Wellness Program
- Short-Term Disability
- Long-Term Disability
- Accident Insurance
- Critical Illness Insurance
- Flexible Spending Accounts
- College - 13 Days Ago
Home Reviewer
- 2M Quality
-
Ocean, DE
PART_TIME
- This is a part time, 1099 position. Work will be completed on weekends, during appointment windows (often, but not limited to 4 hours). Job duties include: Completing appointments and taking photos (a...
- 13 Days Ago
BPS Needs Assessment
- Quality Families
-
Cape May, NJ
PART_TIME,CONTRACTOR
- Having a BPS Needs Assessment performed at a youth's home or community setting is essential to initiating services within the NJ Children's System of Care (CSOC). The assessment is conducted in a home...
- 18 Days Ago
Night Auditor
- Marriott International
-
Atlantic, NJ
PART_TIME
- Additional Information Part TimeJob Number 24070992Job Category Finance & AccountingLocation Sheraton Atlantic City Convention Center Hotel, Two Convention Boulevard, Atlantic City, New Jersey, United...
- 1 Day Ago
Night auditor
- Microtel Inn & Suites
-
Rehoboth, DE
FULL_TIME
- We are looking for a diligent night auditor to join our hotel staff. You will be responsible for bookkeeping and keeping financial records up-to-date, as well as checking guests in and out of the hote...
- 4 Days Ago
Internal Auditor
- Berry Global, inc
-
Cape May, NJ
FULL_TIME
- Contact Please send a copy of your CV to Kevin Farley kevinfarley@berryglobal.com Overview Berry is a Fortune 500 global manufacturer and marketer of plastic packaging products and specialty materials...
- 1 Month Ago
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0 Claims Quality Auditor jobs found in Atlantic City, NJ area
Manufacturing Quality Manager
- CRG Search
-
Williamstown, NJ
- Our client, a $1B+ rapidly growing, recession-proof manufacturer, is an industry leader in the manufacturing of metal fa...
- 5/6/2024 12:00:00 AM
Manager, Enterprise Services Issues & Events (ES Risk)
- Capital One
-
Atlantic City, NJ
- Center 3 (19075), United States of America, McLean, Virginia Manager, Enterprise Services Issues & Events (ES Risk) Ente...
- 5/6/2024 12:00:00 AM
Principal Associate, Enterprise Services Controls Governance (ES Risk)
- Capital One
-
Atlantic City, NJ
- Center 3 (19075), United States of America, McLean, Virginia Principal Associate, Enterprise Services Controls Governanc...
- 5/6/2024 12:00:00 AM
DHS TSL Configuration Management (CM) Specialist
- Global Systems Technologies
-
Egg Harbor Township, NJ
- Job Description Company Overview Global Systems Technologies (GST Inc.) since 1993, enhances national and homeland secur...
- 5/5/2024 12:00:00 AM
Maintenance Manager
- Blue Signal Search
-
Buena, NJ
- Our client manufactures and delivers top-notch packaging products and components nationwide. They are seeking a dynamic ...
- 5/5/2024 12:00:00 AM
Implementation Consultant
- The Judge Group
-
- JOB DESCRIPTION Summary: The Implementation Consultant is responsible for executing and leading the implementation work ...
- 5/4/2024 12:00:00 AM
Quality Technician I -7pm-7am
- Comar
-
Buena, NJ
- QUALITY TECHNICIAN I Actively Hiring - Immediate Openings Hours: full-time position. Competitive pay & benefits: paid ov...
- 5/4/2024 12:00:00 AM
Quality Manager
- Wastequip
-
Sicklerville, NJ
- Wastequip, LLC, the leading manufacturer of recycling and waste handling equipment in North America, is seeking an exper...
- 5/4/2024 12:00:00 AM
About Atlantic City, New Jersey
Atlantic City is a resort city in Atlantic County, New Jersey, United States, known for its casinos, boardwalk, and beaches. In 2010, the city had a population of 39,558.[21][22] It was incorporated on May 1, 1854, from portions of Egg Harbor Township and Galloway Township.[23] It borders Absecon, Brigantine, Pleasantville, Ventnor City, Egg Harbor Township, and the Atlantic Ocean.
Atlantic City inspired the U.S. version of the board game Monopoly, especially the street names. Since 1921, Atlantic City has been the home of the Miss America pageant. In 1976, New Jersey voters legalized casino g...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$49,375 to $60,519
Atlantic City, New Jersey area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Claims Quality Auditor do?
Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019