- Lyra Health Inc (Searcy, AR)
- …twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra ... Empower, the only fully integrated, AI-powered platform combining the highest- quality care and technology solutions.About the RoleLyra is committed to addressing… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a ... corrective actions to improve overall claims accuracy and efficiency. The Claims Quality Specialist will work closely with the Claims Research colleague… more
- AIG (Atlanta, GA)
- Claims , Quality Assurance Specialist - Worker's Compensation Join us as a Claims QA Specialist to make more of your specialist expertise and experience. Make ... your mark in Claims . Our Claims teams are the proven...efficiency. How you will create an impact + Complete quality reviews on all files within program guidelines while… more
- Cognizant (Lansing, MI)
- ** Claims Quality Review** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our Cognizant ... quality standards, processes and procedures and policies + Ensures the claims processing reps adhere to predetermined quality assurance standards and the… more
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- UCLA Health (Los Angeles, CA)
- …random and focus audits of all claim processing activities to identify inaccurate claims adjudication. This will involve reviewing UB04 and CMS 1500 healthcare ... claims and adjustments for accuracy, and appropriate application ...maintain statistical data and ensure compliance with production and quality standards in accordance with department policy. Salary Range:… more
- Quad (Sussex, WI)
- …improvement in paper quality and performance. Key Responsibilities + Credit and Claims Management + File claims related to quality issues across ... outcomes + Operational Documentation + Co-author and maintain templates for production claims and quality tracking. + Contribute to technical specification… more
- UNUM (Columbia, SC)
- …the highest level of quality + Implement claim management and quality claims decision strategies which support business objectives that will achieve ... This position is responsible to lead a high performing claims organization that ensures quality management of...a high performing claims organization that ensures quality management of claims in a multi-disciplined,… more
- Brighton Health Plan Solutions, LLC (NC)
- …reports. The expectations include providing coaching, mentoring, and training while promoting quality and superior customer service. The Claims Supervisor is ... claims requiring adjudication. + Review and process High Dollar claims and conduct quality reviews of claims and logic changes/updates. + Assist Customer… more
- Cognizant (Des Moines, IA)
- …duties and work as part of a team: + Monitor, evaluate and score claims against established quality assurance instruments and standards + Verifying if the ... ** Claims Auditor** (remote) This is a remote position...procedures, including HIPAA policies and procedures, and meets team quality , turnaround time and productivity performance standards and goals… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the end-to-end review,… more
- AIG (Jersey City, NJ)
- …How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims ... Claims Complex Director - Healthcare Professional Liability (HPL)...internal coordination with the corporate legal team. + Achieves quality standards by effectively managing each claim to ensure… more
- HCA Healthcare (Nashville, TN)
- …ability to independently problem solve and proactively manage and resolve claims . Job Responsibilities: Quality + Handle professional medical malpractice ... an organization that invests in you as a Senior Claims Supervisor? At HCA Healthcare, you come first. HCA... and trends in order to support collaboration and quality of care. + Build and maintain strategic alliances… more
- AIG (Boston, MA)
- …on the portfolio. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation ... Job Description Join us as a Claims Analyst IV to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim… more
- Cognizant (Santa Fe, NM)
- …coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/ quality assurance procedures + Must be able to work ... business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical**... Processors to join our growing team. The **Medical** ** Claims Processor** is responsible for the timely and accurate… more
- Honeywell (Phoenix, AZ)
- …and motivated Supplier Quality Lead to spearhead our initiative in managing supplier quality and overseeing monetary claims related to the cost of poor ... monetary claims from suppliers for costs associated with poor quality and additional inspections. + Develop and implement processes for documenting, tracking,… more
- APTIM (Santa Fe, NM)
- …requirements. This role serves as the primary point of escalation and quality assurance for assigned claims , supporting continuous training, technical accuracy, ... procedures to ensure compliance + Monitor the accuracy and quality of claims reviews, flag inconsistencies, and enforce corrective actions where necessary +… more
- Apex Health Solutions (Houston, TX)
- …consistent standards, practices, and processes focused on timely and accurate adjudication of claims to review, evaluate and/or quality control review and final ... issues and appropriately checking with management when necessary, to provide excellent quality in claims adjudication Promotes individual professional growth and… more
- Cedars-Sinai (CA)
- …to all CMS and DMHC guidelines. Investigate and complete open or pended claims . Meet production and quality standards. Job Duties and Responsibilities: + ... **Job Description** The Claims Examiner is responsible for accurately and consistently...preferred. **About Us** Cedars-Sinai is a leader in providing high- quality healthcare encompassing primary care, specialized medicine and research.… more
- USAA (Chesapeake, VA)
- …operations through their teams. + Consistently coach manager on leading their teams on claims handling, inspecting and reviewing quality of claims and ... special and impactful. **The Opportunity** As a dedicated **Director, Claims Operations** you will lead a team of Auto... Operations** you will lead a team of Auto Claims Managers. You will manage and be accountable for… more
