Full-Time Claim Quality jobs

Now available 8 results are consistent

Sort by:relevance - date

CLAIMS QUALITY ASSURANCE SPECIALIST

Conduct comprehensive claim file audit reviews with precision and attention to detail. Provide prompt feedback on emerging trends and critical observations, empowering continuous improvement. Monitor QA review activities at multip...

CompanyPlymouth Rock Assurance
AddressBoston, MA
CategoryManufacturing
Salary$84.8K - $107K a year
Job typeFull-time
Date Posted 2 days ago See detail

Claims Quality Assurance Specialist

Plymouth Rock Assurance

Boston, MA

$84.8K - $107K a year

Conduct comprehensive claim file audit reviews with precision and attention to detail. Provide prompt feedback on emerging trends and critical observations, empowering continuous improvement. Monitor QA review activities at multip...

Claims Quality Assurance Auditor

Altais

Remote

$80,000 - $95,000 a year

Responsible for reviewing claims transaction audit reports, perform claims adjudication quality review to ensure compliance with health plan audits. Complete daily, weekly, and monthly audits. Perform daily review of focused pre-p...

Medicare Claims Quality Audit Manager

Great American Insurance Company

Cincinnati, OH

$78.3K - $99.2K a year

Performs tasks involved with Medicare secondary payer claims reimbursement as necessary, including:Notifies Medicare of beneficiary claims and claim settlements;Conducts conditional payment investigations and communicates payment...

Senior Claims Quality Specialist - Crop

Qbe Insurance Group Limited

Greensboro, NC

Investigate all concerns to ensure compliance with established policies and procedures Participate in analyst/specialist onboarding by sharing technical knowledge, recommending solutions to complex, escalated issues, training on...

Director of Claims Quality - Managed Care

Tandym

Jersey City, NJ

Managing provider reimbursement and analytics, Claims Quality analysts, claims compliance, training and remediation and user acceptance testing (UAT). Overseeing staffing and implementing and maintaining policies, procedures, and...

Claims Quality Assurance Analyst

San Joaquin County Health Commission

Modesto, CA

Reviews claims, appeals, refunds, PLOGS, reinsurance cases, correspondence and other documents. Identifies errors and analyzes to determine cause. Documents findings and sends back for correction and adjudication. Provides feedbac...

Claims Quality Analyst

Versant Health

Remote

$57.1K - $72.3K a year

Responsible for conducting a quality review of functions performed in Client Billing, Enrollment, and Claims. Recommend corrections/changes to the systems, policies, and procedures, as needed, to ensure the highest quality of work...

Claims Quality/Audit Representative - Remote in CA

Optum

San Jose, CA

$16.54 - $32.55 an hour

All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.. Responsible for all aspects of quality assurance from a sample of random claims, check run reviews and Health Plan audits. Provide expertis...