- CVS Health (Washington, DC)
- …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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk Adjustment Data ... Validation (RADV) audit and any other chart coding functions, by performing...and provides information to management team to further enhance quality and/or provider education. Work with leadership and third-party… more
- Northrop Grumman (Annapolis Junction, MD)
- …SOWs/Tech Docs, issuing RFPs, analyzing proposals, evaluating commerciality claims , approving source justifications and technical evaluations, completing price/cost ... negotiating T&Cs/pricing/schedule/GR&A/etc., awarding and modifying subcontracts, preparing compliant procurement audit files in accordance with FAR and company policies,… more
- Elevance Health (Hanover, MD)
- …letters. + Maintains accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and documentation ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of...purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- Elevance Health (Washington, DC)
- …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
- Northrop Grumman (Dulles, VA)
- …Space Systems Sector is seeking a Senior Principal Supply Chain Subcontracts Specialist for our Tactical Space Systems Division. **This is an on-site position ... reviewing SOWs/Tech Docs, issuing RFPs, analyzing proposals, evaluating commerciality claims , approving source justifications and technical evaluations, completing price/cost… more