• Claim Audit Quality

    CVS Health (Sacramento, CA)
    …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
    CVS Health (10/16/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Walnut Creek, CA)
    …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise,...Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation… more
    Elevance Health (09/23/25)
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