- CVS Health (Albany, NY)
- …solutions to make health care more personal, convenient and affordable. Position Summary laim Audit Quality Analysts need to have a wide depth and breadth of ... of detail and review.A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple groups. Knowledge in… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist , you will work with internal teams to provide cutting-edge solutions that will directly ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...clinical, and other data insights that directly improve the quality and efficiency of patient care. At LogixHealth, we're… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit ... with Home Health operations and customers to drive improvement in the quality of services delivered to patients. Responsibilities + Code diagnosis accurately… more
- Generac Power Systems (Waukesha, WI)
- …of mind through reliable products and exceptional support. The Warranty Quality Specialist is responsible for monitoring warranty claim rates and supporting ... **Warranty Quality Specialist ** **Company** Generac Power Systems...Duties:** + Analysis of warranty information and processing warranty claims per warranty guidelines + Conduct warranty claim… more
- Beth Israel Lahey Health (Burlington, MA)
- …and accurately appeal claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review to ensure the ... **Work Shift:** Day (United States of America) The Billing Specialist role specializes in high dollar claims ,...claim and it was billed appropriately. The Billing Specialist will work directly with Supervisors and Managers to… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …to recovery and repayment of inappropriate payments discovered as a result of claims audit or investigation. + Maintains awareness of regulations and current ... Coordinates periodic review and analysis of Bon Secours Mercy Health provider claims denial reports, operational assessment reports, internal quality control… more
- Beth Israel Lahey Health (Burlington, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 4. Reviews claim forms for the accuracy of procedures, ... provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and… more
- CVS Health (Phoenix, AZ)
- …- Executes both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard ... effective and timely support. - Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements as well as… more
- Medical Mutual of Ohio (OH)
- …to software quality assurance and testing. . Strong knowledge of claims adjudication systems and processes. . Strong analytical and problem-solving skills with ... of training and experience. . 2 years' experience as a Business Systems Specialist or equivalent experience with software quality assurance and testing. .… more
- Beth Israel Lahey Health (Burlington, MA)
- …**Scheduled Hours:** 40 **Work Shift:** Day (United States of America) The Denial Specialist role is vital to ensure that hospital denied accounts are thoroughly ... for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement. The role also includes...with third party payor representatives in order to resolve claim issues. 5. Utilize CAC or other electronic coder… more
- Beth Israel Lahey Health (Burlington, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 5. Reviews claim forms for the accuracy of procedures, ... and interprets third party payments, adjustments and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 5) Reviews claim forms for the accuracy of procedures, ... and interprets third party payments, adjustments and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts,… more
- Cedars-Sinai (CA)
- …Coding Audit experience with auditing skills covering coding/billing accuracy, claims processing, denial management, and revenue cycle with a strong focus on ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We also were...**Req ID** : 2173 **Working Title** : Lead Coder Specialist **Department** : CSRC Coding Audit **Business… more
- Elevance Health (Norfolk, VA)
- **Pharmacy Quality Assurance Specialist ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... Delivery and Specialty Pharmacy is looking to hire a Quality Assurance (QA) Specialist ** . This **Pharmacy...Identifies and reports on systemic issues which create ongoing quality concerns. + Generates monthly reports of audit… more
- HCA Healthcare (Brentwood, TN)
- …want to join an organization that invests in you as a Denial Coding Review Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... We are looking for a dedicated Denial Coding Review Specialist like you to be a part of our...researching, analyzing, and resolving outstanding clinical denials and insurance claims . What you will do in this role: +… more
- Naval Air Systems Command (WA)
- …within and external to Quality Competency such as Discrepancy Work Orders, Quality Deficiency Reports (QDR), Quality Audit Reports, etc. Additional ... Summary You will serve as a QUALITY ASSURANCE SPECIALIST in the Industrial...the Summary section of this announcement. However, if you claim veteran's preference, you will be required to submit… more
- UIC Government Services and the Bowhead Family of Companies (Dayton, OH)
- **Overview** FISCAM BUSINESS SPECIALIST (AFSAC): Bowhead seeks a FISCAM Business Specialist to support the AFSAC contract located in Dayton, OH. This position ... Assistance Command (AFSAC). This includes providing Federal Information System Controls Audit Manual (FISCAM) knowledge and supporting the preparation of AFSAC's key… more
- Heritage Ministries (Gerry, NY)
- …do. Heritage Ministries is in growth mode and currently seeking an Accounts Receivable Specialist to support the delivery of quality services and the financial ... of the organization by ensuring accurate billing, timely Submission of claims , monitoring claim status, researching rejections and Denials, documenting… more
- Air National Guard Units (Hickam AFB, HI)
- …GUARD TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a QUALITY ASSURANCE SPECIALIST , Position Description Number D1818000 and is part of ... the maintenance organization designed to assist maintenance managers. Serves as the Quality Assurance Specialist (QAS) for the planning, implementation and… more
- Houston Methodist (Katy, TX)
- …and the CBO team to ensure timely compliance with and completion of audit or data requests. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** + Assists management in ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more