Claims Quality Auditor jobs in Jamestown, NY
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 - House Supervisor
- Quality Clinicians
-
Kane, PA
FULL_TIME
-
**BASIC KNOWLEDGE AND PERFORMANCE REQUIREMENTS:**
- Must possess a current license in PA as a registered nurse.
- Must possess knowledge of medical asepsis, body mechanics, personal care of residents, correct use and care of equipment, observation techniques, reporting and recording, and thorough knowledge of nursing theory and its application.
- Must be willing to possess knowledge of and comply with regulations, policies, procedures, and philosophy of the institution.
- Must maintain a courteous and professional manner toward residents, visitors, and co-workers, with a dedication to meeting the needs of the elderly.
- Must have awareness of cost containment, utilize time fully, and properly care for equipment.
- Must possess the ability to accept and follow written and verbal directives.
- Must utilize good communication and observation skills.
- Exercise independent judgment and effectively deal with emergency situations.
**GENERAL DUTIES:**
- Administers and records medication, treatments, and monitoring as ordered, and reports and documents resident responses.
- Accurately transcribes physician's orders.
- Completes monthly summaries and updates care plans to reflect the resident's current condition.
- Notifies the RN Supervisor immediately of a significant change in a resident's condition.
- Reports and records changes in resident condition to the RN Supervisor.
- Communicates resident transfers to immediate family and department heads via email.
- Assists physicians with rounds, examinations, and treatments as needed.
- Collects laboratory specimens and arranges for delivery to the hospital with accurate and complete requisitions.
- Assists with postmortem procedures and collection of resident's clothing and belongings.
- Encourages resident participation in scheduled activities.
- Reports changes in resident condition, care plan changes, and any special assignments to be carried out.
- Assists RN Supervisor with annual evaluations of nursing assistants.
- Accurately completes incident reports or assists team members in writing reports.
- Documents weights and vital signs and follows up as needed.
- Maintains a clean and orderly work area.
- Performs housekeeping assignments as scheduled.
- Submits maintenance requests as needed.
- Maintains a clean, safe, and healthy environment and reports potential safety hazards.
- Supervises and directs resident care by nursing assistants to ensure the prescribed plan of care is carried out.
- Performs additional duties as directed by supervisor.
- Assists in the orientation of new nursing staff.
- Adjusts staffing assignments as needed to ensure good resident care.
- Conducts team conferences as needed.
- Assures that staff is familiar with changes in policies and procedures.
- Updates the daily census as needed.
- Monitors NA documentation for completeness and compliance with regulations.
- Collects data for quality assurance studies as directed.
- Monitors nurse aide job performance for compliance with infection control practices.
- Provides direct care for residents as needed.
- Seeks clarification or guidance to perform job responsibilities when in doubt.
- Attends in-services, department and staff meetings, and committee meetings as required.
- Assists CNAs on the hall as needed.
**DRESS CODE:**
- Uniforms: Any colored scrubs.
- Shoes: Clean and in good repair, no open-toe sandals.
- Hair: Clean.
- Sweaters: Cardigans, vests of any color.
- Jewelry: No large or dangling earrings or necklaces.
- No heavy perfumes.
- Name tags: Worn daily.
- No short or jogging pants. - 23 Days Ago
Nurse - HCQU
- Partners for Quality
-
Warren, PA
FULL_TIME
- Overview: ORGANIZATION: Milestone Centers Inc. DEPARTMENT: HCQU POSITION: Nurse STATUS: Full Time; 37.5 hours / week SCHEDULE: Weekdays, 37.5 hours per week (Daylight hours, No weekends or holidays) L...
- 30 Days Ago
ENERGY AUDITOR
- Chautauqua Opportunities Inc
-
Jamestown, NY
FULL_TIME
- DescriptionPosition Data:Title: Energy AuditorGrade: 7 Exempt: _____ Non-Exempt: _X____Reports to: Construction ManagerBasic Function or Position Summary:Determines work scope for energy efficiency an...
- 13 Days Ago
Auditor B
- External Opportunities
-
Ridgway, PA
FULL_TIME
- Key Responsibilities: • Accurately observe, measure and record product characteristics Act properly and timely when non-conforming product or conditions are detected Use precise measurement equipment ...
- 20 Days Ago
Product Auditor - 2nd Shift
- Anderson Precision
-
Jamestown, NY
FULL_TIME
- Join a small successful machining company that has been in the Jamestown area for over 130 years. We pay for experience but experience is not required. We will train you. Anderson Precision currently ...
- 10 Days Ago
Product Auditor - 2nd Shift
- Anderson Precision
-
Jamestown, NY
FULL_TIME
- Join a small successful machining company that has been in the Jamestown area for over 130 years. We pay for experience but experience is not required. We will train you. Anderson Precision currently ...
- 7 Days Ago
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0 Claims Quality Auditor jobs found in Jamestown, NY area
Woodworking Assembler
- The Adecco Group
-
Jamestown, NY
- Production Associate - Woodworking Furniture Maker. Jamestown, NY - Full-time$17-18 per hour. About Us:Adecco is working...
- 4/19/2024 12:00:00 AM
Manufacturing Assembler
- Adecco Staffing, USA
-
Jamestown, NY
- If you're looking for a manufacturing job, then look no further!Adecco is looking for candidates who thrive in a fast-mo...
- 4/19/2024 12:00:00 AM
Quality Technician I
- American Refining Group Inc.
-
JAMESTOWN, NY
- Compensation: Full-time, Salary Non-Exempt (NE28) Company Information: ARG is the longest continuously operating refiner...
- 4/18/2024 12:00:00 AM
Quality Technician I
- American Refining Group Inc.
-
CELORON, NY
- Compensation: Full-time, Salary Non-Exempt (NE28) Company Information: ARG is the longest continuously operating refiner...
- 4/18/2024 12:00:00 AM
Manufacturing Assembler
- Adecco US, Inc.
-
Jamestown, NY
- If you're looking for a manufacturing job, then look no further! Adecco is looking for candidates who thrive in a fast-m...
- 4/18/2024 12:00:00 AM
Meat/Seafood Clerk>
- Tops Friendly Markets
-
Falconer, NY
- Tops Friendly Markets - 110 South Work Street - [Grocery Clerk / Team Member / FT & flexible PT schedules available] - A...
- 4/18/2024 12:00:00 AM
Assembler/laborer 2nd shift
- Combined Systems Inc.
-
Jamestown, NY
- General assembly/labor is considered an entry level job position. Candidates hired in this position could work in multip...
- 4/17/2024 12:00:00 AM
Controller
- PeopleSuite LLC
-
Bradford, PA
- Scope of Position The Controller position entails reporting directly to the Regional Controller and overseeing financial...
- 4/15/2024 12:00:00 AM
About Jamestown, New York
Jamestown is a city in southern Chautauqua County, New York, United States. The population was 31,146 at the 2010 census and was estimated at 29,591 in 2017. Situated between Lake Erie to the northwest and the Allegheny National Forest to the south, Jamestown is the largest population center in the county. Nearby Chautauqua Lake is a freshwater resource used by fishermen, boaters and naturalists.
Notable people from Jamestown include comedian Lucille Ball, U.S. Supreme Court justice and Nuremberg chief prosecutor Robert H. Jackson, naturalist Roger Tory Peterson, singer Natalie Merchant, and N...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$43,542 to $53,369
Jamestown, New York 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