Claims Quality Auditor jobs in Reno, NV

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)

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Claims Examiner
  • Universal Health Services, Inc.
  • Reno, NV FULL_TIME
  • Responsibilities

    Job Summary: The Claims Examiner is detail-oriented and will be responsible for reviewing and adjudicating health insurance claims for all products and all lines of business, including but limited to Medicare, Self-Funded, Fully Insured, ensuring accuracy compliance with policies and regulations and timely settlements. This role involves assessing claims, verifying information, and communicating effectively with internal stakeholders, members, providers and their office staff and other insurance companies.


    Qualifications

    Qualifications and Requirements:

    • High school diploma or equivalent required.
    • Associate degree in healthcare administration, Business Administration, or related field preferred.
    • Two years' experience as a Health Insurance Claims Examiner or similar role in the insurance industry preferred.
    • In-depth knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and healthcare billing procedures.
    • Familiarity with health insurance policies, regulations, and compliance standards.
    • Strong analytical skills with attention to detail and accuracy in claims processing.
    • Excellent communication and interpersonal abilities to interact effectively with customers and stakeholders.
    • Proficiency in using computer systems, including claims processing software and Microsoft Office Suite.
    • Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
    • Certification in Health Insurance Portability and Accountability Act (HIPAA) compliance is a plus.
    • Strong commitment to confidentiality and ethical conduct in handling sensitive healthcare data.

    EEO Statement

    All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

    We believe that diversity and inclusion among our teammates is critical to our success.

    Notice

    At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-800-852-3449.

     

  • 19 Days Ago

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Supervisor, Claims
  • UHS
  • RENO, NV FULL_TIME
  • Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Pr...
  • 25 Days Ago

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Claims Examiner
  • UHS
  • RENO, NV FULL_TIME
  • Responsibilities Job Summary: The Claims Examiner is detail-oriented and will be responsible for reviewing and adjudicating health insurance claims for all products and all lines of business, includin...
  • 1 Month Ago

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Regional company driver
  • Quality Carriers
  • Winnemucca, NV FULL_TIME
  • Requirements : Must have CDL-A with 3 year Tractor Trailer experience in the last 5 years or 1 year of Tanker Experience in the last 10 years. Must have 5 years of safe driving and no incidents Must h...
  • Just Posted

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Class-A CDL Local Company Driver
  • Quality Carriers
  • Golconda, NV FULL_TIME
  • Class-A CDL Local Company DriverRED HOUSE, NVResponsibilitiesRequirements: Must have CDL-A with 1 year Tractor Trailer experience in the last 3 years or 1 year of Tanker Experience in the last 10 year...
  • 26 Days Ago

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Warehouse Auditor
  • XMG
  • Reno, NV FULL_TIME
  • Xpedient is a full-service 3rd party logistics provider. We have experience helping a diverse client base in warehousing services, transportation management, supply chain management, order fulfillment...
  • 20 Days Ago

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0 Claims Quality Auditor jobs found in Reno, NV area

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Bookkeeper
  • RIBUS
  • Sparks, NV
  • Who We Are:: Founded in 1992 as a functional ingredient manufacturing company, RIBUS, Inc. supplies natural and organic ...
  • 4/26/2024 12:00:00 AM

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Senior Electrical Test Engineer
  • Legrand Data Center Solutions
  • Reno, NV
  • Legrand has an exciting opportunity for a Sr. Test Engineer to join the Data Center Power and Control Division Team in R...
  • 4/24/2024 12:00:00 AM

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Manager l, Manufacturing
  • Click Bond
  • Carson City, NV
  • Under moderate supervision, schedules, plans, and supervises the day-to-day operations of one or more departments to mee...
  • 4/24/2024 12:00:00 AM

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SUPERVISORY QUALITY ASSURANCE SPECIALIST
  • Air National Guard Units
  • Reno, NV
  • Summary This position is for a SUPERVISORY QUALITY ASSURANCE SPECIALIST, PD# D1819000 , part of the Nevada Air National ...
  • 4/23/2024 12:00:00 AM

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Warehouse Supervisor
  • Nutrient Survival
  • Reno, NV
  • Warehouse Supervisor Job Description Company Description: Nutrient Survival provides high-quality performance nutrition ...
  • 4/22/2024 12:00:00 AM

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Associate Director, GMP Quality Control
  • Sumitomo Pharma
  • Carson City, NV
  • Associate Director, GMP Quality Control Sumitomo Pharma America (SMPA) is focused on delivering therapeutic and scientif...
  • 4/22/2024 12:00:00 AM

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Internal Revenue Agent (Senior Revenue Agent (Examiner) -12 MONTH ROSTER
  • Department Of The Treasury
  • Reno, NV
  • Duties WHAT IS THE SBSE - SMALL BUSINESS SELF EMPLOYED DIVISION? A description of the business units can be found at: ht...
  • 4/22/2024 12:00:00 AM

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Senior Restaurant Manager
  • BJ's Restaurants
  • Sparks, NV
  • Overview: Do you challenge yourself to always do things right and do them better? Then you will thrive at BJ’s Restauran...
  • 1/16/2024 12:00:00 AM

Reno (/ˈriːnoʊ/ REE-noh) is a city in the U.S. state of Nevada, located in the northwestern part of the state, approximately 22 miles (35 km) from Lake Tahoe. Known as "The Biggest Little City in the World", Reno is known for its casino industry. It is the county seat of Washoe County. The city sits in a high desert at the foot of the Sierra Nevada and its downtown area (along with Sparks) occupies a valley informally known as the Truckee Meadows. The city is named after Union Major General Jesse L. Reno, who was killed in action at the Battle of South Mountain on Fox's Gap. Reno, with an esti...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$46,209 to $56,638
Reno, Nevada area prices
were up 2.5% from a year ago

Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019